Epidermal proliferation and the neutrophilic infiltrates of experimental cutaneous candidiasis in mice

Summary A mouse model of cutaneous candidiasis was used to determine if the prominent neutrophilic infiltrates in the infected skin of nonimmune animals were responsible for inducing the early phase of epidermal proliferation seen in these infections. Both the organisms and resulting neutrophilic microabscesses were found in the cellular layers of the epidermis at 12 h after inoculation, and were then extruded together to a more superficial site in the stratum corneum over the next 1–2 days. The degree of epidermal proliferation elicited at the site of the Candida foci, as determined from the thickness of the cellular layers of the epidermis, was the same for foci with neutrophils as for those without, even when the latter came from severely leukopenic animals. The location of neutrophils within the infected skin or the numbers of organisms present did not seem to make a difference with respect to the degree of epidermal proliferation produced at the site of Candida foci. These data suggest that in acute experimental cutaneous Candida infections the organisms can elicit a vigorous epidermal proliferative response in the absence of the neutrophilic infiltrates usually seen in these infections.     

皮肤念珠菌病患者多部位分离菌株DNA分型研究

目的 比较皮肤念珠菌病患者不同部位分离菌株基因相似性,推测皮肤念珠菌病多部位感染的可能途径。方法 采用PCR扩增引物P-Ⅰ和P-Ⅱ扩增出白念珠菌染色体25SrDNA片段和特征性的基因片段重复序列片段,结合两种扩增结果进行分型,并将870bp大小的特征性的基因片段重复序列片段用限制性内切酶EcoRⅠ和ClaⅠ消化。结果 来自19例皮肤念珠菌病患者的41株白念珠菌被分为6型,同一患者不同部位分离菌株基因型相似,不同个体间基因型有差异。结论 分离自皮肤念珠菌病患者不同部位的致病菌株基因型相同,提示其发病可能与外源性再发感染无关。     

慢性皮肤黏膜念珠菌病

报告1例白念珠菌引起的皮肤黏膜念珠菌病，患儿女，7岁，全身散在丘疹5年，加重伴指疣状增生1年，同时出现口腔黏膜，皮肤及甲板损害，双手掌疣状赘生物，手指末节残缺，变形。口腔黏膜白斑，北部皮损组织及粪便真菌培养均为白念珠菌生长。皮肤组织病理改变为表皮角化明显，角质层中查见大量真菌菌丝。经伊曲康唑，制霉菌素等药治疗后，皮损逐渐好转。     

Congenital cutaneous candidiasis: a rare and unpredictable disease

Congenital cutaneous candidiasis (CCC) is an extremely rare disorder that presents within the first 6 days of life. The manifestations ranges from diffuse skin eruption without any systemic symptoms to respiratory distress, hepatosplenomegaly, sepsis, and death. We report a neonate who presented with generalized skin eruptions at birth, characterized by erythematous macules and papules. The eruption involved head, face, neck, trunk, and extremities. Candida albicans was demonstrated on direct KOH smear, skin biopsy. The disease implies a congenital intrauterine infection and is different from neonatal candidiasis, which manifests as thrush or diaper dermatitis. The infection is acquired from the maternal genital tract in an ascending fashion. Clinical features, direct smear examination of specimen, and appropriate cultures are useful in differentiating the lesions from other more common dermatoses of the neonatal period. Topical antifungal therapy is sufficient unless systemic candidiasis is present. Prognosis for congenital cutaneous candidiasis is good.     

继发性皮肤浆细胞瘤

报告1例继发于多发性骨髓瘤（multiple myelonm,MM)的皮肤桨细胞瘤，患者女，44岁，皮损为多发性，来源于MM直接蔓延和血行转移，组织病理检查示瘤细胞呈结节状浸润，免疫组化染色结果示IgG阳性表达，患者于皮损出现后78d死亡。     

皮角32例分析

目的:分析32例皮角患者的临床特点。方法:对32例皮角患者的临床资料进行回顾性分析。结果:皮损位于头颈部24例、躯干部2例、上肢2例、下肢4例;组织病理示病毒疣20例(62.5%)、脂溢性角化症5例(15.6%)、癌前病变5例(15.7%)、毛囊角化症1例(3.1%)和原位鳞状细胞癌1例(3.1%)。结论:皮角好发于身体的暴露部位,大部分皮角为良性病变。     

Prospective trial for the clinical efficacy of anogenital skin care with miconazole nitrate-containing soap for diaper candidiasis

Anogenital skin care for the elderly remains an umbrella term concerning protective and non-interventional regimens, particularly for ordinary diaper users. Our recent investigation has demonstrated the preventive effect of daily anogenital washing with miconazole nitrate-containing soap to the development of diaper candidiasis. We extended this work to cover our hypothesis as to whether the miconazole soap has a therapeutic benefit in genital candidiasis. The study outline includes: (i) the enrollment of 21 bedridden inpatients (84 ± 9 years; eight men and 13 women) who were diagnosed clinically and mycologically with genital candidiasis, and who had never received topical and/or systemic antifungal agents; (ii) administration of anogenital washing with 0.75% miconazole-containing soap once daily for 4 weeks; and (iii) assessment of clinical symptoms and detection of Candida materials by culture and microscopic examination. As assessed by clinical symptom scoring for incontinence-associated dermatitis (IAD), the ratio of patients with severe to moderate symptoms dramatically decreased by 2 weeks and 10 of 21 patients became symptom-free at 4 weeks. The IAD clinical severity score was significantly decreased at 4 weeks. Compared with the baseline positivity, both microscopic and cultured Candida-positive rates were significantly decreased at 4 weeks after washing. All culture-detected fungi were Candida albicans. Severe adverse events did not occur in all participants. Individual medical and risk factors had no significant correlation with clinical severity and duration of candidiasis on variance analysis. In conclusion, topical washing with miconazole soap is a safe and reliable non-medical approach for soothing diaper-associated genital candidiasis in bedridden inpatients in whom it is difficult to perform prompt medical examination.     

乳酸菌阴道胶囊在治疗复发性外阴阴道假丝酵母菌病中的应用

目的:探讨乳酸菌阴道胶囊治疗复发性外阴阴道假丝酵母菌病的临床疗效。方法:选择285例复发性外阴阴道假丝酵母菌病患者,研究组142例,用制霉素阴道栓1枚/d,放置阴道深部连续7 d,月经前后1周内再使用乳酸菌阴道胶囊2粒置于阴道深部,连续7d。对照组143例,用制霉素阴道栓1枚/d,放置阴道深部连续7 d,,观察用药后1周、4周、8周临床症状、实验室检测以及复发率等情况。结果:用药1周后复查研究组和对照组总有效率分别是98.5%、97.9%,差异无统计学意义(P>0.05),4周后、8周后复查研究组和对照组复发率分别为1.40%、8.39%,差异有统计学意义(P<0.05)。结论:制霉素阴道栓和乳酸菌阴道胶囊联合应用治疗复发性外阴阴道假丝酵母菌病效果满意且复发率低。     

Probiotics for oral and vulvovaginal candidiasis: A review

Dermatologists commonly prescribe medications such as antibiotics and corticosteroids that can increase the risk for candidiasis. Though conventional antifungals are often effective against candidiasis, they are not without side effects and species of Candida are gaining resistance. Probiotics help treat conditions such as post‐antibiotic diarrhea and infectious diarrhea, and thus have the potential to help with Candida infections, as well. For this reason, we provide an overview of therapies prescribed in dermatology that may increase the risk for candidiasis, and we review the literature on whether probiotics are useful in the treatment and prevention of oral and vulvovaginal candidiasis to help dermatologists treating the condition be better informed about their supplemental use with conventional antifungals.     

Paraneoplastic subacute cutaneous lupus erythematosus associated with cholangiocarcinoma

Subacute cutaneous lupus erythematosus (SCLE) is a dermatosis that occurs in genetically predisposed individuals. The exogenous stimulus that triggers this condition is usually unknown; however, medication is often implicated. Malignancy is a rare cause. We present a case of paraneoplastic SCLE to cholangiocarcinoma and briefly review the features of this interesting entity.     

季也蒙念珠菌所致口腔念珠菌病1例

患者男性,３４岁,舌部、口腔内颊部粘膜白膜,每遇夏季增多增厚,天气转冷白膜减少变薄,反复发作５年。发作时张口困难,感觉疼痛。真菌学检查鉴定为季也蒙念珠菌。给予伊曲康唑２００ｍｇ／ｄ共７ｄ为１个疗程,连用３个疗程治愈。     

Cutaneous arteriolitis: A novel cutaneous small vessel vasculitis disorder clinicopathologically different from cutaneous polyarteritis nodosa and cutaneous venulitis

Cutaneous vasculitis can be classified into two types based on the affected vessel size: small vessel vasculitis predominantly affecting dermal venules, and muscular vessel vasculitis as found in cutaneous arteritis predominantly affecting arteries located at the dermal-subcutaneous junction. We describe two cases with a novel small vessel vasculitis disorder, which exclusively affected arterioles in the mid-dermis, and show clinical and pathological difference distinct from cutaneous polyarteritis nodosa and cutaneous venulitis. Both patients were male, and presented with painful infiltrative plaques, involving the palms, soles, and thighs without extracutaneous involvement except for fever and arthralgia. Histopathological examination revealed vasculitis in the mid-dermis characterized by a predominant infiltration of neutrophils with vessel wall fibrinoid necrosis and leukocytoclasia identical to the features of leukocytoclastic vasculitis, except that the affected vessels were arterioles rather than venules. Serological examinations showed normal levels of serum complements, immune complexes, and antineutrophil cytoplasmic antibodies, and vasculitis disorders associated with systemic diseases were excluded in both patients. The patients showed a good response to short-term treatment with prednisolone up to 30 mg. This novel cutaneous arteriolitis clinicopathologically different from both cutaneous venulitis and cutaneous arteritis appears to be a skin-limited disorder.     

2%酮康唑制剂治疗小儿念珠菌皮炎110例临床观察

目的：为选择治疗小儿念珠菌皮炎适当而有效的药物和剂型，并了解其疗效。方法：用酮康唑片2g加入锌氧油或炉甘石洗剂中，配成2％酮康唑油剂或洗剂。外涂患处，每日3次，治疗1周观察。结果：1周治疗后，治愈98例（89.09%)，显效9例（8.18%)，好转3例（2．72％），总有效率为97．27％。结论：外涂2％酮康唑油剂、洗剂治疗小儿念珠菌皮炎无刺激性是目前安全有效理想的外用药。     

Onychodystrophy as the only sign of congenital candidiasis

Congenital candidiasis infection often presents as a skin rash with variable involvement of nails and mucous membranes. Isolated nail involvement is rare, may present late, and can often be managed with topical antifungal medication. We report a case of congenital candidiasis limited to the fingernails that resolved completely within 3 months with topical treatment.     

Giant cutaneous rhinosporidiosis

A young male with a single, huge subcutaneous lesion of rhinosporidiosis is reported. The diagnosis was suggested by the presence of nasal rhinosporidiosis and confirmed by fine-needle aspiration cytology (FNAC) from the skin lesion. This is the second report of giant skin lesions in rhinosporidiosis, from our department.     

阴道念珠菌病患者阴道分泌物总RNA提取方法的研究

目的 探索一种简单有效的人体阴道分泌物标本总RNA提取方法并验证其可行性。方法 采用人体上皮细胞与念珠菌标准菌株的混合物（106 ∶ 106）,对匀浆、玻璃珠和液氮研磨三种破壁方法,纯化柱、酚两种提取方法组合产生的5种不同RNA提取方法进行比较。并将提取效果最好的方法应用于临床标本。结果 5种方法均可提取出总RNA,其中,热酚法提取质量浓度最高,达到0.6546 g/L,其次为RNeasy试剂盒提取方法为0.6010 g/L,玻璃珠法为0.2678 g/L,匀浆后TRIzol法为0.2284 g/L,液氮研磨后TRIzol法为0.2115 g/L。但电泳结果显示,以液氮研磨后TRIzol提取质量最好,而且标准菌株及培养细胞混合物两种细胞成分RNA均被提取,RT-PCR以及荧光定量PCR验证结果显示,该方法可以应用于临床标本RNA提取。结论 液氮研磨后TRIzol法是一种简单而有效的阴道分泌物临床标本RNA提取方法,而且提取物可以满足常规下游实验的需求。     

Treatment of widespread cutaneous larva migrans with thiabendazole

Cutaneous larva migrans (CLM) is a characteristic eruption that is caused by penetration and migration in the skin of nematode larvae. Both animal and human hookworms have been implicated in the pathogenesis of the condition, with Ancylostoma braziliensis and A. caninum being the most common among them. CLM is quite common in tropical areas, but, due to travelling, several cases have also been described in Europe. We present a patient with CLM who presumably contacted the disease during a holiday in Singapore. The patient was treated successfully with oral thiabendazole.