聚甲基丙烯酸甲酯(爱贝芙)的临床应用

目的：评价注射聚甲基丙烯酸甲酯（商品名：爱贝芙，artecoll）治疗皱纹、轮廓塑形和软组织凹陷的安全性与有效性。方法：使用爱贝芙注射填充剂（主要有效成分为聚甲基丙烯酸甲酯微球）对463例患者1162处进行注射治疗。以改善皱纹、组织凹陷及面部轮廓塑形。所有患者均在注射前以及注射后即刻、1周、3个月、6个月、12个月和24个月进行随访和照像。由皮肤科医生和患者进行综合评估。结果：所有注射部位均在注射后即刻获得不同程度的改善，有效率为98．1％；注射后1周、3个月、12个月和24个月的综合评分分别为：3．78、2．91、2．82、2．79分，有效率为：97．1％、68．3％、64．3％、63．0％。未发生肉芽肿、过敏反应、感染等并发症。结论：爱贝芙是一种安全有效的永久性注射填充剂。     

水光针注射美容致面部异物肉芽肿一例

患者,女,27岁。面部起丘疹伴痒1个月。4个月前在当地美容院给予水光针注射。临床表现结合组织病理诊断为面部异物肉芽肿。给予皮损内局部注射复方倍他米松注射液,皮损消退。     

耳轮多发环状肉芽肿

报告1例耳轮多发环状肉芽肿。患者男,33岁。双侧耳轮小结节伴触痛3年。系统检查无异常。实验室和辅助检查均正常。皮损组织病理检查示真皮中下部栅栏状肉芽肿,中央胶原变性坏死,周围上皮样细胞和组织细胞浸润,阿新蓝染色阳性诊断:环状肉芽肿。治疗:给予复方倍他米松局部封闭注射治疗后皮疹消退。     

肉芽肿性酒渣鼻并发结节性红斑一例

患者,女,41岁。因面部丘疹半年,双下肢结节伴触痛20天余就诊。结合临床、病理等检查,面部诊断为肉芽肿性酒渣鼻,下肢诊断为结节性红斑。 给予盐酸米诺环素胶囊 100 mg 日2次 、维胺脂胶囊25 mg日3次,甘草酸二胺肠溶胶囊150 mg 日3次 ;外用他克莫司软膏。治疗2周后双下肢皮疹消退,疼痛消失,面部皮疹有所减轻,患者连续治疗2个月后停药。5个月后随访,面部皮损复发。     

肉芽肿性口周皮炎二例

报告2例肉芽肿性口周皮炎.例1男,6岁.面部红斑、丘疹5个月就诊.曾外用糖皮质激素软膏后皮疹渐增多.例2女,28岁.口周、鼻周红斑、小丘疹2个月余就诊.2例均表现为面部腔口周围直径1 ～3mm大小的淡红色坚实小丘疹,皮损组织病理检查:真皮毛囊周围上皮样细胞肉芽肿改变.结合临床表现及组织病理学检查,2例均确诊为肉芽肿性口周皮炎.例1口服琥乙红霉素颗粒200 mg/次,每日4次、1％克林霉素凝胶和0.03％他克莫司软膏外用,治疗2个月后皮疹完全消退,1个月后口周皮疹又复发.例2在行组织病理活检后皮疹自行消退,提示本病具有临床自愈倾向.     

类固醇酒渣鼻

面部反复外用高效类固醇激素后,成人和儿童均可发生类固醇酒渣鼻。作者报告5例因反复外用氟化类固醇激素而发病的患者,这些药物均是患者未经医师处方私自购买使用的。例1.女性,76岁,可能是由于轻度脂溢性皮炎面部外用氟化类固醇激素已5年。面部呈明显红斑,大的丘疹和结节。经服用四环素、外用氢化可的松皮疹消失。例2.女性,72岁,鼻部因瘙痒外用倍他米松2年。局部发红、小脓疱。服用四环素、外用氢化可的松后皮疹迅速消退。例3.女性,46岁,外用氟化类固醇激素约8年出现类固醇酒渣鼻。经四环素内服、外用氢化可的松1月后消退,但残留红斑及毛细血管扩张。例4.男性,20岁,由于轻发的非特异性皮炎外用倍他米松1年,出现红斑、丘疹和结节,亦经同样治疗得到显著好转。例5.     

肉芽肿性口周皮炎二例

报告2例肉芽肿性口周皮炎。例1男,6岁。面部红斑、丘疹5个月就诊。曾外用糖皮质激素软膏后皮疹渐增多。例2女,28岁。口周、鼻周红斑、小丘疹2个月余就诊。2例均表现为面部腔口周围直径1—3mm大小的淡红色坚实小丘疹,皮损组织病理检查：真皮毛囊周围上皮样细胞肉芽肿改变。结合临床表现及组织病理学检查,2例均确诊为肉芽肿性口周皮炎。例1口服琥乙红霉素颗粒200mg/次,每日4次、1％克林霉素凝胶和0．03％他克莫司软膏外用,治疗2个月后皮疹完全消退,1个月后口周皮疹又复发。例2在行组织病理活检后皮疹自行消退,提示本病具有临床自愈倾向。     

类似环状肉芽肿的面部皮肤型孢子丝菌病一例

患者,女,54岁.左面颊红斑、丘疹、结节1个月.皮肤科查体见左侧面部类似环状肉芽肿的簇集浸润性环状红色斑块.皮损组织病理检查及真菌培养,确诊为"面部皮肤型孢子丝菌病".给予伊曲康唑胶囊口服治疗3个月,皮损消退,随访6个月无复发.     

皮肤软组织填充相关异物肉芽肿

近年来,随着皮肤软组织填充技术的高速发展,注射填充抗衰老操作数量急速增长,然而与之相关的不良反应也不断剧增。其中异物肉芽肿是皮肤软组织填充最常见的异物反应之一,在临床上常见,表现为软组织填充术后,皮肤出现慢性反复性红肿或结节囊肿,可伴随瘙痒或疼痛。本文将对皮肤软组织填充相关异物肉芽肿的发生机制、危险因素、分类及临床处理进行综述。     

Nd:YAG激光治疗文眉所致的异物反应

5例女患者分别于文眉6～12个月后局部发生异物反应．自觉局部疾痒，脱屑。有2例曾用电离子治疗无效，另3例曾局部外用皮质类固醇或封闭治疗均无效，就诊时患接触性皮炎6个月至2年不等，检查见眉弓处有红斑或浸润性斑块，上覆干燥性鳞屑或浆液性痂皮。治疗方法：5例患者使用Nd:YAG四波段激光仪治疗，选择波长1064nm、脉冲能量密度6．0－8．OJ／。’、脉冲宽度5－IOl。。、光斑直径2On。m万例经I次治疗后自觉病痒明显减轻，浸润渐消退，鳞屑减少。3－4个月后恢复至文眉前状态，炎症消退，文眉痕迹均清除。另2例经过1次治疗后症状明显减轻…     

Panniculitis with crystals induced by etanercept subcutaneous injection

Panniculitis with lipid crystallization within adipocytes may be seen in several disorders, including crystal‐storing histiocytosis, gouty panniculitis, subcutaneous fat necrosis of the newborn, post‐steroid panniculitis, sclerema neonatorum, oxalosis and subcutaneous fungal infections by mucormycosis, zygomycosis or aspergillosis. Panniculitis at the sites of subcutaneous injection of drugs are frequent, but to our knowledge no crystals have been described in the drug‐induced panniculitis at the sites of subcutaneous injections. We report on a patient who developed a panniculitis with lipid crystallization at the site of etanercept injection.     

国产争光霉素局部注射治疗瘢痕疙瘩

瘢痕疙瘩,是较难治疗的常见多发皮肤病.作者自去年以来,对门诊50例瘢痕疙瘩患省采用国产争光霉素局部注射治疗,取得甚为满意的效果,现简要报道如下.     

Primary cutaneous nocardiosis associated with intra-articular corticosteroid injection.

A 65‐year‐old woman presented to our clinic with a 2‐month history of papulopustular lesions on her right hand that had progressively increased in size and number. She had a 15‐year history of psoriasis vulgaris and had developed digital arthralgias within the preceding few months. A diagnosis of psoriatic arthropathy was made and she was treated by multiple intra‐articular steroid injections on the back of the right hand. One month after the last injection, the lesions had developed over the treatment area. The patient had no apparent history of trauma, but had grown flowers for years. Dermatologic examination revealed three fluctuating, erythematous, superficial, scaling nodules, measuring 0.5‐1.5 cm, on the second and fourth metacarpal bones and on the proximal phalanx of the fourth finger. Many scattered papulopustular lesions were also present on the back of the right hand ( Fig. 1 ).

Figure 1 Open in figure viewer PowerPoint Nodules and papulopustular lesions found on the back of the right hand on admission     

Plasma cell cheilitis treated with intralesional injection of corticosteroids

Plasma cell cheilitis is an idiopathic, benign, inflammatory condition characterized by a dense band-like infiltrate of plasma cells in the oral mucosa. In addition to the lips, the disease can affect the penis, vulva, buccal mucosa, palate, gingiva, tongue, epiglottis, and larynx. Some authors have shown the effectiveness of topical or intralesional corticosteroids; however, there have been many reports describing poor therapeutic responses to topical steroids. We describe three patients with plasma cell cheilitis whose clinical condition responded rapidly to the intralesional injection of corticosteroids.