皮肤B细胞性淋巴瘤临床病理及免疫组化研究

应用免疫组化方法对５例皮肤Ｂ细胞性淋巴瘤进行研究。５例分为四种亚型：皮肤免疫细胞性淋巴瘤，中心细胞性和中心母细胞性各１例，中心细胞－中心母细胞性２例。ＣＩＬ出现中心母细胞及瘤巨细胞，向高度恶性淋巴瘤转化，免疫组化显示：５例ＣＤ４５，ＣＤ２０阳性，ＣＤ４５Ｒｏ均阴性。１例ＣＣＢＬ又示κ、λ、ＩｇＧ，ＩｇＭ均呈阳性，为双标记阳性，探讨其发性机理，并将各亚型与皮肤Ｂ细胞性假性淋巴瘤及组织细胞性淋巴瘤进行     

皮肤透明细胞淋巴瘤三例

皮肤透明细胞淋巴瘤（clearcellymphoma）是皮肤T细胞淋巴瘤的一个亚型,比较少见。我们近见３例,报道如下。临床资料：男２例,女１例,年龄３３～５２岁,平均４５．３岁,病程２～５个月,平均３．５个月。２例伴有发热,１例年前有皮肤淋巴瘤病史,３例皮肤损害均表现为红色浸润性斑块,质硬,边界清楚,浸润深浅不一,大小不等,蚕豆大至拳头大,１例压痛明显,１例浸润性斑块中心坏死结痂,１例局限于右乳房（见图１）,２例广泛分布于胸背部及躯干四肢（见图２）,１例伴有口腔粘膜糜烂和溃疡,１例颌下及颈部淋巴结肿大。实验室检…     

皮肤恶性淋巴瘤新亚型及几种罕见的类型（三）

５原发性皮肤滤泡性淋巴瘤（ｐｒｉｍａｒｙｃｕｔａｎｅｏｕｓｆｏｌｉｃｕｌａｒｌｙｍｐｈｏｍａ）此瘤约占所有皮肤Ｂ细胞淋巴瘤的４０％～４５％［１］。Ｂｕｒｇ认为它属于半恶性ＣＭＬ［２］。５１临床表现：此种ＣＭＬ多见于男性老年人。皮肤结节、斑块或肿瘤好...     

原发性皮肤中心母细胞淋巴瘤1例

报告１例原发性皮肤中心母细胞淋巴瘤。患者，男，９２岁。右小腿被蚊虫叮咬后出现肿块１年半，增多、扩大、破溃伴左小中块２个月。血常规、Ｘ光胸片、腹部Ｂ超、骨髓检查未划常。病检示肿瘤细胞形态似中心母细胞，免疫组化证实瘤细胞的Ｂ细胞性。ＥＢＥＲ原位杂交末检测到ＥＢ病毒。患者未作放化疗，９个月后死亡。     

皮肤B细胞淋巴瘤一例

原发于皮肤的Ｔ细胞淋巴瘤（ＣＴＣＬ）多见，如蕈样肉芽肿（ＭＦ）和Ｓｅｚａｒｙ综合征。而皮肤Ｂ细胞淋巴（ｃｕｔａｎｅｏｕｓＢ－ｃｅｌｌｌｙｍｐｈｏｍａ，ＣＢＣＬ）则少见［１～３］，皮肤损害酷似ＭＦ的更少见。在此我们报告一例，并附以皮肤病理、免疫组化及超微结构观察。一、临床资料患者男，５５岁。因全身皮肤的浸润性斑片、斑块性损害１年半于１９９３年２月４日入院。患者于１９９１年９月开始于右上肢出现约钱币大淡红色斑片，略痒，１０余天后自行消退，但一周后，局部出现同样损害，且逐渐增多，发展到躯干及四肢、皮疹…     

盐裂皮损围围皮肤直接免疫荧光检查诊断表皮下水泡病

本文报告了应用盐裂皮损周围皮肤直接免疫荧光检查（ＤＩＦ），诊断２２例表皮下水疱病的结果，所有２２例表皮下水泡病盐裂皮损周围皮肤ＤＩＦ均显示ＩｇＧ免疫复事物沉淀在表皮侧，真皮侧或表皮真皮两侧，阳性率为１００％，其中表皮侧１７例，表皮真皮两侧均有２例，此１９例的均为大泡性类天疱疮（Ｂｐ），真皮侧３例，２例为获得性大疱性表皮性松解症（ＥＢＡ），１例大疱性系统性红斑狼疮（ＢＳＬＥ），３例天疱疹和４例正常人     

盐裂皮损围围皮肤直接免疫荧光检查诊断表皮下水疱病

本文报告了应用盐裂皮损周围皮肤直接免疫荧光检查（ＤＩＦ）诊断２２例表皮下水疱病的结果，所有２２例表皮下水疱病盐裂皮损周围皮肤ＤＩＦ均显示ＩｇＧ免疫复合物沉积在表皮侧、真皮侧或表皮真皮两侧，阳性率为１００％。其中表皮侧１７例、表皮真皮两侧均有２例，此１９例均为大疱性类天疱疮（Ｂｐ）；真皮侧３例，２例为获得性大疱性在皮松解症（ＥＢＡ）、１例为大疱性系统性红斑狼疮（ＢＳＬＥ）。３例天疱疮和４例正常人皮肤均阴性。此法简便，易行，准确可靠，重复性好，值得推广使用。     

疱液在诊断表皮下自身免疫性大疱病中的意义

目的：探讨表皮下自身免疫性大疱病疱液中抗基底膜带（ＢＭＺ）自身抗体的情况及在诊断中的意义。方法：应用非盐裂皮肤及盐裂皮肤间接免疫荧光技术（ＩＦ）检测３８例表皮下自身免疫性大疱病患者疱液和血清中ＩｇＧ、ＩｇＡ、ＩｇＭ、ＩｇＥ及ＩｇＧ亚型ＩｇＧ１～ＩｇＧ４抗ＢＭＺ抗体及滴度，并检测疱液和血清中结合补体Ｃ３的特异性抗ＢＭＺ抗体。结果：（１）疱液和血清中抗ＢＭＺ抗体及滴度和结合补体Ｃ３的特异性抗ＢＭＺ抗体均无显著性差异。（２）大疱性类天疱疮患者的疱液和血清中ＩｇＧ抗ＢＭＺ抗体的亚型分布相同，主要为ＩｇＧ１和ＩｇＧ４。结论：疱液可作为ＩＩＦ检测表皮下大疱病抗ＢＭＺ抗体的另一个有价值的标本来源。     

白塞病的血管损害与免疫学改变

目的：探讨白塞病（ＢＤ）的血管损害以及免疫学改变。方法：对４５例ＢＤ患者的临床及病理学资料进行分析。结果：１４例皮肤组织活检、１例扁桃体活检及１例食道粘膜活检病理改变均符合小血管炎症。２例（２／１２）皮肤直接免疫荧光（ＤＩＦ）阳性，为真皮小血管壁ＩｇＭ和Ｃ３ｃ沉积。４例并发心血管系统损害，其中２例为冠状动脉瘤伴血栓形成。１例为脑栓塞性舞蹈病，１例为食道下段溃疡并出血。有多项免疫学指标异常。１０例检     

儿童获得性大疱表皮松解症(附4例报道)

儿童获得性大疱表皮松解症（ＥＢＡ）是一种自身免疫性表皮下大疱病,比较少见。本文报道４例儿童ＥＢＡ,年龄为１、４、７、１４岁,均为男性。临床上似营养不良性大疱表皮松解症２例,儿童型线形ＩｇＡ大疱病２例。３例有口腔损害,伴血疱,萎缩性瘢痕和栗丘疹。病理为表皮下水疱。ＤＩＦ均示ＩｇＧ和Ｃ３呈线状分布于基底膜带,３例还见ＩｇＡ,１例见ＩｇＭ沉积于基底膜带。盐裂ＤＩＦ示３例ＩｇＧ沉积于真皮侧。ＩＩＦ示３例Ｉ     

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.