原发性皮肤奴卡菌病一例

患者,男,72岁。右侧手背、前臂结节伴肿痛3天。组织病理学:(右侧前臂)表皮缺失,真皮可见大片坏死组织,大量中性粒细胞、淋巴细胞及少许多核巨细胞浸润。右侧前臂分泌物细菌培养示:星形奴卡菌生长。诊断为原发性(淋巴型)皮肤奴卡菌病。给予哌拉西林钠舒巴坦钠,夫西地酸乳膏,红光照射治疗后逐渐好转。     

原发性皮肤巴西奴卡菌感染一例

<正>临床资料患者,男,36岁。因左侧上肢肿胀性红斑、结节、伴疼痛7天入院。7天前,患者因左上肢蚊虫叮咬、反复搔抓后逐渐出现局部红斑、肿胀,触压有轻微疼痛,无畏寒、发热,无心慌、胸闷,无头昏、头痛等不适。于当地诊所静脉滴注"头孢菌素"3天,病情无缓解。我科门诊以"皮肤感染"收入院。查体:T     

肺部奴卡菌病并皮肤播散1例（附文献复习）

奴卡菌病是一种少见的皮肤和／或系统感染性疾病，主要由星形奴卡菌感染引起。笔者近期诊治一例，现报道如下，并复习近期文献报道，就奴卡菌病的临床表现、诊断、治疗及预后等做一简要分析，以供临床诊治参考。     

急性原发性皮肤巴西奴卡菌感染

报告1例原发性皮肤巴西奴卡菌感染。患者男,26岁。因左侧面部红肿伴发热、左颈部淋巴结肿大4 d入院。体格检查:左侧面部钱币大皮肤肿物,质软,中央少许浆脓分泌物,部分结痂。脓液细菌培养和鉴定为巴西奴卡菌,经复方磺胺甲恶唑口服治疗后好转。     

HIV阳性患者合并皮肤奴卡菌病一例

患者,女,66岁。2年前无明显诱因鼻尖部出现浸润性斑块、结节、厚重的黄痂,皮损逐渐增多。HIV抗体（+）,皮损表面脓性分泌物培养提示奴卡菌。进一步培养菌株提取基因组DNA,经扩增测序后,提示该奴卡菌分型为巴西奴卡菌。     

奴卡氏菌性足菌肿1例

患者男，34岁，左膝外伤后1年局部皮下组织出现红肿，硬化，窦道流脓，肌腱肿块，伴腹股沟淋巴结肿大，组织病理诊断肌腱肿块为足菌肿，窦道内肉芽组织培养有巴西奴卡氏菌生长，以青霉素G和复方甲基异恶唑连续用药2个月结合外科手术治疗，皮损和肿块完全消退，随访8个月未见复发。     

奴卡菌性足菌肿

报告1例奴卡菌性足菌肿。患者男,56岁。左腹股沟术后出现皮肤红肿、破溃、脓液溢出半年。组织病理检查可见大量肉芽性炎性浸润,并见小脓肿形成,其内可见硫磺颗粒;分泌物涂片+抗酸染色镜检见阳性菌,菌丝内连串阳性颗粒;脓液培养见奴卡菌,诊断为奴卡菌性足菌肿。给予复方磺胺甲恶唑联合头孢曲松治疗,皮损完全消失。     

豚鼠奴卡氏菌引起足菌肿1例报告（附药敏测定）

报告国内首例由豚鼠奴卡氏菌引起的足菌种，并进行药敏测定，为今后临床选择用药提供了实验依据。用纸片法测定此菌对１０种抗生素敏感，２６种中药试管内抑菌生长的初步实验观察表明，１１种中药对此菌有抑菌作用。     

皮肤着色芽生菌病1例

1临床资料 患者男,35岁,农民,主因右下肢皮肤疣状结节斑块破溃、渗出,反复发作进行性加重13年,于2003年4月26日收住院.患者入院前13年,小腿内侧外伤后出现散在黄豆及蚕豆大小暗红色疣状结节,逐渐增大形成斑块,表面破溃,有脓性分泌物.     

皮肤混合型孢子丝菌病1例

1临床资料 患者,女,42岁,山区农民.因左侧面部多发性红斑结节、斑块、溃破流脓8个月,左前臂、左臀部孤立性红斑结节10个月,于2003年8月就诊.     

Primary Cutaneous Nocardiosis

A 35-year-old male presented with multiple discharging sinuses and fluctuant swelling on right side of face which started after a vehicular accident three year back. The lesions did not respond to routine antibiotics treatment but went on increasing. Gram smear showed typical acid fast branching filaments suggestive of nocardiosis, which was confirmed by culture. Patient received co-trimoxazole for three and a half month. When seen again after three years, all the lesions had healed with puckered scarring. Patient had received co-trimoxazole for three and a half months with dramatic improvement.     

小范围发生皮肤诺卡菌病23例

目的 报道国内首见群体发生的皮肤诺卡菌病23例。方法 详细检查了23例患者的皮疹表现，对6例患者的标本进行了病原学鉴定，同时对可能的发病原因进行了调查。结果 发现全部患者同住一个自然村，发病均与臀部肌内注射有关，每例患者均于肌内注射治疗后2-10个月内出现臀部（肌肉注射部位）结节，脓肿，部分皮损破溃成溃疡及窦道，病原学检查证实为星形奴卡菌。结论 23例皮肤奴卡菌病的发生均与肌内注射有关。     

结节性皮肤淀粉样变性1例

患者女,48岁。右胸部丘疹和结节4年。皮损组织病理示:真皮乳头、网状层、皮下组织及血管周围见大小不一均质性团块样物质沉积,刚果红染色示:橙红色阳性。诊断:结节性皮肤淀粉样变。     

结节性原发性皮肤淀粉样变1例

患者男,36岁。右上唇须部小肿物2年余,渐增大,轻痒。组织病理:真皮全层可见较多呈淡粉红色均匀一致的团块状沉淀物,其间有裂隙;结晶紫染色淀粉样蛋白呈鲜明紫红色;透射电镜真皮内小血管周围及胶原纤维间可见纤细、排列无序的淀粉样纤维。诊断:结节性限局性原发性皮肤淀粉样变。经90锶局部贴敷治疗消退。     

结节性皮肤淀粉样变性一例

目的报告1例结节性限局性原发性皮肤淀粉样变性。方法结合皮损的临床特征、组织病理、刚果红染色、偏振光显微镜检查等,明确疾病的诊断。结果患者的皮损表现为上臂、腰腹部多发黄红色隆起性结节或斑块。组织病理示:真皮乳头、网状层、皮下组织及细血管周围大小不一均质性团块样物质沉积,刚果红染色示橙红色阳性,偏振光检查可见苹果绿双折光。结论结节性限局性原发性皮肤淀粉样变性诊断明确,临床少见。     

原发性皮肤B细胞性淋巴瘤1例

报告原发性皮肤B细胞淋巴瘤1例。患者男，40岁，因背部肿块逐渐增大10月而就诊。组织病理为真皮弥漫淋巴样细胞浸润，见异型细胞，免疫病理为L26( )，UCHL1(-)，CD30(-)，ALK(-)，MPO(-)。     

A Case of Lymphocutaneous Nocardiosis with a Review of Lymphocutaneous Nocardiosis Reported in Japan

An 82-year-old Japanese male developed nodules and ulcers along the lymphatics after a fall in the garden of his house resulting in injuries to the dorsum of his left hand which lasted for 3 months. Nocardia brasiliensis was isolated from a nodule, supporting a diagnosis of the lymphocutaneous type of nocardiosis. He had previously developed generalized bone metastasis from prostatic cancer, and his resulting depressed immunity might have played a part in the nocardiosis genesis. Sixteen cases of the lymphocutaneous type of nocardiosis reported in Japan were reviewed.     

A Case of Primary Cutaneous Mucinous Carcinoma with Neuroendocrine Differentiation

Primary cutaneous mucinous carcinoma is a rare malignant tumor that originates from the deepest portion of the eccrine sweat duct. Common sites of involvement are the face and scalp. Biopsy shows dermal epithelial cell islands embedded in mucin pools separated by fibrous septae. It is difficult to differentiate this tumor histologically from metastatic adenocarcinoma. Recurrence after excision is common but metastases are rare. We report a primary cutaneous mucinous carcinoma with neuroendocrine differentiation on the right cheek of a 63-year-old man.     

原发性皮肤外周T细胞淋巴瘤(非特殊类型)1例

患者男,60岁。全身结节、肿块十余年。左大腿结节组织病理示:真皮全层及皮下组织大量瘤细胞呈结节状密集分布,瘤细胞形态呈多形性,胞体大,核异型,可见较多多核巨细胞。免疫组化示:CD2,CD3和TIA-1均阳性,CD4,CD5及CD8均弱阳性,CD7,CD20,CD30,CD56,GrB及ALK均阴性,Ki-67显示高增殖指数(70%)。诊断:原发性皮肤外周T细胞淋巴瘤(非特殊类型)。