胫前黏液性水肿1例

患者女,46岁.因双下肢斑块7年,于2011年3月至我科就诊.患者2004年无诱因出现食欲增加,消瘦、乏力等症状,于当地医院查三碘甲状腺原氨酸0.45 nmol/L(正常值0.09～0.28 nmol/L,以下同),甲状腺吸碘功能试验3 h为0.352(<0.250)24 h为0.705(<0.450),诊断为甲状腺功能亢进.同时双胫前出现钱币大淡红色斑块,逐渐增大、隆起,并向双足部蔓延.     

胫前黏液性水肿1例

患者女,26岁。因双下肢斑块伴微痒不适1年余,于2005年4月10日来我科就诊。曾有甲状腺功能亢进(简称甲亢)病史2年,服用过丙硫氧嘧啶、左甲状腺素、普奈洛尔治疗。体格检查:双眼球明显外突。甲状腺Ⅱ度肿大,质硬,心率128次/min,律齐。皮肤科检查:双侧小腿胫前中下1/3区见多个圆形、卵圆形暗红色坚实水肿性斑块或结节(图1A),直径1.5～3.0cm,皮损凹凸不平,压之无凹陷,皮温不高,无压痛,表面皮肤紧张、菲薄,干燥发亮,毛囊口扩大呈猪皮样外观。实验室检查:血常规中白细胞4.2×109/L、单核细胞0.15,血清总三碘甲腺原氨酸(TT3)12nmol/L(正常值1.23…     

胫前黏液性水肿1例

患者男。42岁。4年前出现食欲增加、乏力、心悸,在当地医院诊断为甲状腺功能亢进,予以他巴唑、甲状腺片和雷公藤等治疗半年余后症状改善。3年前于右侧小腿胫前出现一黄豆大结节,并逐渐增大、增多,累及足背,无明显自觉症状。期间仍以口服他巴唑治疗为主,血清三碘甲状腺原氨酸（T3）、血清总甲状腺素（T4）、促甲状腺激素（TSH）检测水平基本正常或略有升高。右足背皮损曾予以手术切除。术后又复发,其余皮损仍缓慢增大、增多。既往体健,否认家族成员中有类似病史。为进一步诊治于2007年8月来我院就诊。     

胫前黏液性水肿1例

患者男,19岁。双胫前皮肤肿胀起硬结及斑块1年,突眼心悸半年。检查见面部潮红,良性突眼,甲状腺Ⅱ°肿大,双下肢皮肤有大片硬实斑块,边界清楚,以胫前为主。临床及组织病理检查确诊。     

胫前黏液水肿1例

患者男,30岁。因下肢起红斑4个月余,于2004年6月16日来我科就诊。4个月前患者无明显诱因右下脚出现片状红斑、结节,无痒痛及其他自觉症状,未做任何治疗。2个月前左下肢相继出现数个红斑,面积逐渐增大,逐来我院就诊。发病以来,无发热,关节痛等症状,食欲、睡眠尚可,二便正常。患者5年前曾在外院就诊,诊断为“甲亢”,口服他巴唑30mg/d,因用药缺乏规律,症状控制不满意。     

综合疗法治疗胫前黏液性水肿1例

<正>报告1例甲亢并发大面积足及胫前黏液性水肿且严重影响生活的患者,我们采用手术切除局部皮损等多种治疗方法,获得满意效果。1病历摘要患者男,42岁。15年前于当地医院确诊为甲状腺功能亢进(简称甲亢),接受治疗~([1]),甲状腺功能恢复正常。8年前患者双胫前出现大片暗红色水肿性斑块,质韧,压之无凹陷,无痛痒不适,后皮疹逐渐增多,并多发黄豆至蚕豆大赘生物,表面光滑,质较硬。多地医院均诊断为黏液性水肿,给予静脉注射甲泼尼龙和曲安奈     

胫前黏液性水肿一例

<正>临床资料患者,男,36岁。主因双下肢散在肿物1年余、加重半年,于2010年12月3日就诊。1年前患者双胫前出现散在黄豆大小斑丘疹,无自觉症状,未予特殊处理,近半年来皮损逐渐增大,数目增多,无疼痛、瘙痒。患者既往有甲亢病史3年,于当地治疗,现血清T3、T4水平均正常。体格检查:双侧凸眼征(+),甲状腺未触及,心、肺检查未见明显异常。皮肤科检查:双胫前散在边界清楚的圆形或卵圆形坚实红色结节或斑块,其中右胫前两处斑块较大,近端斑块约5cm×6 cm、远端约10 cm×8 cm,隆起、凹凸不平,表面有蜡样光泽,界限清楚,质硬,无压痛,皮肤张     

胫前黏液性水肿14例临床病理分析

目的:分析研究胫前黏液性水肿的临床和组织病理学特点.方法:对14例胫前黏液性水肿患者的临床表现进行回顾性分析,采用苏木精-伊红染色、阿新蓝染色进行组织病理学检查.结果:14例胫前黏液性水肿患者多表现为胫前肤色、淡红色或褐黄色坚实水肿性斑块或结节.真皮中下部可见大量淡蓝色的线状或颗粒状粘蛋白沉积,胶原纤维分离,部分成纤维细胞数目增多,阿新蓝染色阳性.治疗局部采用皮质类固醇激素皮损内注射疗效显著.结论:胫前黏液性水肿的临床及组织病理具特征性,手术所见亦有助于本病的诊断与鉴别诊断.     

胫前黏液水肿

患者男,40岁. 主诉:头晕、头痛、心悸伴多汗、乏力3年,双下肢出现结节、肿块2年余. 现病史:患者2年前双下肢胫前皮肤肿胀,出现肿块、结节,伴有轻度疼痛及瘙痒,于2007年9月20日至我科就诊.3年前患甲状腺功能亢进症,一直未接受正规治疗.     

胫前黏液性水肿一例

患者男．48岁。因双侧胫前至足背部皮肤结节、斑块样肿胀。不痛不痒3年而于2002年3月6日来我院就诊。患者1999年2月骑摩托车时不慎碰伤左膝部．当心局部肿胀、疼痛伴皮肤轻擦伤。半月后伤处肿痛消退．双侧小腿开始出现水肿、青紫,左膝皮肤擦伤处出现一黄豆大小肿物．不痛不痒。1个月后双小腿肿胀开始缓慢向下移动,症状逐渐加重,     

胫前粘液性水肿1例

1 临床资料 患者女,47岁.1995年患甲状腺功能亢进,经同位素131I治疗后出现继发性甲状腺功能减低.1998年左足背出现结节性肿物,大小约1 cm×2 cm,质韧,与皮肤相连,当地医院外科以"左足背表皮样囊肿"切除,组织病理:皮肤伴有玻璃样变的胶原纤维组织,并出现散在汗腺组织.     

Pretibial Myxedema with Graves' Disease: A Case Report and Review of Japanese Literature

We report a case of pretibial myxedema with Graves' disease in an 18-year-old Japanese woman. The physical examination revealed waxy indurated plaques with prominent hair follicle openings and nonpitting edema disseminated on her lower legs. Histology from an edematous lesion revealed that the dermis was markedly thickened with abundant mucin, especially hyaluronic acid, and the collagen fibers in this portion were splitting up into fibrils. We also reviewed 112 cases of pretibial myxedema reported in the Japanese literature.     

肩背部及胫前黏液性水肿1例

患者男,24岁.患甲状腺功能亢进史,发现背部包块及双下肢皮肤弥漫结节2年余,皮损组织病理检查确诊为黏液性水肿.     

Pretibial Myxedema

Pretibial myxedema or localized myxedema or thyroid dermopathy is an autoimmune manifestation of Graves' disease. It also occasionally occurs in Hashimoto's thyroiditis. Lesions of thyroid dermopathy are usually asymptomatic and have only cosmetic importance. Advanced forms of dermopathy are associated with elephantiasis or thyroid acropachy. Almost all cases of thyroid dermopathy are associated with relatively severe ophthalmopathy. Usually ophthalmopathy appears first and dermopathy much later. All patients with localized myxedema have high serum concentrations of thyroid-stimulating hormone receptor antibodies, indicating the severity of the autoimmune condition. Occurrence of thyroid dermopathy in areas other than pretibial skin indicates a systemic process. Similar to Graves' ophthalmopathy, thyroid-stimulating hormone receptors in the connective tissue may be the antigen responsible for the immune process. Both humoral and cellular immune mechanisms are involved in the stimulation of fibroblasts and the production of large amounts of glycosaminoglycans. Localization in the pretibial area relates to mechanical factors and dependent position. Diagnosis of thyroid dermopathy is based on signs and typical pretibial skin lesions in association with a history of Graves' hyperthyroidism and ophthalmopathy. In some cases, skin biopsy is needed for confirmation. The lesions are usually mild and are overshadowed by more symptomatic ophthalmopathy. Most cases of thyroid dermopathy do not require any therapy. In mildly severe symptomatic cases and when there is cosmetic concern, topical corticosteroids applied under occlusive dressing are beneficial. In more severe cases, systemic immunomodulation may be necessary; however, conclusive evidence for long-term efficacy of these modalities is lacking. When significant edema and elephantiasis are present, local compressive therapy may have added benefit. In mild cases that do not require treatment, 50% of patients achieve complete remission after several years. Severe cases that receive topical corticosteroids or other therapies do not have a better outcome than untreated milder cases. Current treatment modalities for thyroid dermopathy and acropachy are at best palliative. Better and safer means of immunomodulation are needed.     

茄病镰刀菌病1例

患者男,65岁。右手背反复出现肿胀、溃疡7年余,多次给予碘化钾、伊曲康唑等治疗,均初始有效。经过真菌涂片、真菌培养、组织病理鉴定为茄病镰刀菌病。     

骨膜增生厚皮症1例

报告骨膜增生厚皮症1例。患者男,20岁。头面部皮肤增厚,皮纹加深,伴双手足十指及趾末端皮肤增厚、肥大,进行性加重5年。骨骼X线示长骨及手足骨骨皮质增厚。诊断:骨膜增生厚皮症(原发性)。目前未予特殊治疗,继续观察,必要时可进行美容方面的对症治疗。     

Basidiobolomycosis—A Case Report

A case of subcutaneous phycomycosis with clinical, histological and mycological studies is reported. An excellent result with oral potassium iodide therapy was observed.     

Basidiobolomycosis: A Case Report

A case of subcutaneous entomophthoromycosis caused by Basidiobolus haptosporus in a five year-old child was presented. The case has unusual aspects: extensive ulceration, caseation necrosis and a lack of response to potassium iodide. The lesion was cured using an association of potassium iodide and ketoconazole.