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We report the case of a 69-year-old woman who presented a papular eruption on the eyelids. Histological features revealed a tuberculoid granuloma with a central caseating necrosis. Laboratory and radiological investigations revealed no tuberculosis and no systemic granulomatosis. Absence of vascular symptoms, inefficiency of cyclines and histopathological findings excluded granulomatous-type rosacea. Lupus miliaris disseminatus faciei (LMDF) was our final diagnosis. On the basis of our findings and a literature review, we believe that LMDF is an entity distinct from either skin tuberculosis or granulomatous-type rosacea. However, its name is confusing, and we propose to change it to 'facial idiopathic granulomas with regressive evolution (FIGURE)'.  相似文献   

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. . . Evidence-based medicine?   总被引:1,自引:0,他引:1  
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We report a case of secondary syphilis in a 54-year-old, bisexual, HIV positive man. Although syphilis is a well-known sexually-transmitted infection, it is not widely seen nowadays. However, a possible diagnosis of syphilis should not be overlooked in any individual, irrespective of HIV status.  相似文献   

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Background: Hyaluronic acid fillers have become popular soft tissue filler augmentation agents over the past several years. Q.O.Fill (JW Pharmaceutical Co., Ltd., Seoul, Korea) is a newly developed soft tissue augmentation agent using Tissuefill (hyaluronic acid derivatives) mixed with platelet-rich plasma (PRP). The purposes of this study were to describe the Q.O.Fill method and evaluate the outcome of face augmentation. Methods: A retrospective chart review was performed over a 2-year period. Seventy-five Asian participants with a mean age of 43.5 years were enrolled in the study. Mean total injection volume (baseline and touch-up) per participant was 8.9 mL. All participants underwent injection of Tissuefill mixed with PRP, Q.O.Fill. The results were evaluated using photographs and according to patients’ satisfaction. Results: Six months after the last injection, 100% of participants had improvement. At month 6, 97.3% of participants remained least improved over the baseline, and 90.7% felt much better or a little better until 2 years after the injection. The incidence of complications was low. Conclusions: The study showed that Q.O.Fill injection resulted in a very good aesthetic outcome and few adverse events. We believe that a facial augmentation with Tissuefill mixed with PRP is a safe and effective treatment method.  相似文献   

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Birt-Hogg-Dubé syndrome: a novel marker of kidney neoplasia.   总被引:1,自引:0,他引:1  
BACKGROUND: Birt-Hogg-Dubé syndrome (BHD) is a dominantly inherited predisposition for development of fibrofolliculomas, trichodiscomas, and acrochordons. Concurrent internal tumors, such as colonic polyps and renal carcinoma, have been described in patients with BHD. OBJECTIVE: To evaluate kindreds with familial renal tumors for cutaneous manifestations of BHD. DESIGN: One hundred fifty-two patients from 49 families underwent complete oral and skin examination. Skin lesions were identified by their clinical appearance, and the diagnosis was confirmed by results of histologic examination. Individuals underwent screening for familial renal neoplasms. SETTING: A tertiary referral research hospital. PATIENTS: Individuals with familial renal tumors and their asymptomatic at-risk relatives. MAIN OUTCOME MEASURE: We determined whether any form of renal cancer is associated BHD. RESULTS: We identified 3 extended kindreds in whom renal neoplasms and BHD appeared to segregate together. Two kindreds had renal oncocytomas and a third had a variant of papillary renal cell carcinoma. Thirteen patients exhibited BHD. Seven individuals, including a set of identical twins, had renal neoplasms and BHD. An additional 4 patients (3 deceased and not examined) in these families had renal neoplasms but not BHD. Birt-Hogg-Dubé syndrome without renal neoplasms was present in 6 individuals. Thirteen patients with fibrofolliculomas and trichodiscomas presented clinically with multiple smooth skin-colored to grayish-white papules located on the face, auricles, neck, and upper trunk. Oral papules were present in 9 of 28 and achrochordons in 11 of 28 patients. Features of BHD not previously appreciated included deforming lipomas in 5, collagenomas in 4, and pulmonary cysts in 4 of 28 patients. Families with BHD did not display germline mutations in the von Hippel-Lindau gene or in the tyrosine kinase domain of the MET proto-oncogene. CONCLUSIONS: Birt-Hogg-Dubé syndrome may be associated with familial renal tumors. Birt-Hogg-Dubé and renal tumors segregate together in an autosomal dominant fashion. Patients with BHD and their relatives are at risk for development of renal tumors. Therefore, patients with BHD and their relatives should undergo abdominal computed tomography and renal ultrasound screening for renal tumors.  相似文献   

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