羟基氯喹治疗光线性皮肤病的回顾性分析

采用羟基氯喹对148例光线性皮肤病进行治疗,观察了羟基氯喹治疗多形性日光疹,慢性光化性皮炎,外源性光敏性皮炎,迟发性皮肤卟啉病,痘疮样水疱病以及日光性荨麻疹的临床效果。结果表明羟基氯喹对光线性皮肤病有一定疗效。并可作为首选药物用于多形性日光疹和迟发性皮肤卟啉病的治疗。     

A Case of Morpheaform Sarcoidosis

Sarcoidosis is an idiopathic multisystem disease with various cutaneous presentations, and it is characterized by the presence of non-caseating granulomas in the affected organs. The specific manifestations are papules, plaques, nodules, ulcers and scar. We report here on a variant of sarcoidosis on a 71-year-old woman who showed an indurated plaque on the forearm. Her lesion''s appearance was clinically similar to that of a morphea and the appearance of the lesion was unlike the commonly observed manifestations of sarcoidosis.     

小儿皮肌炎临床分析

对１６例６岁以内小儿皮肌炎进行长期随访研究。１６例患儿中，男１０例，女６例，月龄１４￣７２月，平均３９．７月，其中皮肌炎１４例，无肌病皮肌炎２例。按Ｓｐｅｎｃｅｒ报告分３型。首次发病者７例，慢性复发者５例，慢性持续者２例。治疗以强的松为主，仅有２例合用环磷酰胺。１６例中３例出现软组织钙化，可能与强的松治疗剂量不足、间断治疗有关。     

丘疹型皮肤结节病1例

患者男,44岁。面部散在丘疹1年余。查体见面部散在绿豆至黄豆大小丘疹,边界清楚,表面光滑,质硬,以眼周为重。皮损组织病理示无干酪样坏死的上皮样细胞肉芽肿。诊断:丘疹型皮肤结节病。     

Atrophying Pityriasis Versicolor: Is This a New Variant of Pityriasis Versicolor?

An atypical clinical form of pityriasis versicolor has been infrequently reported, in which cutaneous atrophy is associated with individual pityriasis versicolor lesions. The pathogenesis of this atrophy remains unclear, but is believed to be a delayed-type hypersensitivity reaction to antigens derived from the Malassezia species. A 60-year-old man presented with multiple, slightly scaly, and depressed maculopatches or plaques on the trunk and extremities. Our microscopic examination of the skin scrapings on a KOH preparation revealed numerous short hyphae and spores. The patient was treated daily with 200 mg of itraconazole in combination with topical antifungals, achieving clinical improvement and mycological recovery, which was confirmed upon follow-up 1 month later. This is the first case report of atrophying pityriasis versicolor in Korea. It needs to be differentiated from other atrophying disorders of the skin.     

丘疹型结节病一例

患者女,56岁。面部、四肢起红色丘疹2个月。查体见面部、四肢散在绿豆至黄豆大小丘疹,边界清楚,表面光滑,质地中等。皮损组织病理示:真皮内上皮样细胞构成的裸结节,境界清楚,周围少量淋巴细胞浸润,无干酪样坏死。诊断:丘疹型结节病。     

Branch-shaped Cutaneous Hypopigmentation and Atrophy after Intralesional Triamcinolone Injection

Cutaneous changes after local corticosteroid administration may include dermal atrophy, hyperpigmentation, alopecia, and hypopigmentation. Linear hypopigmentation and atrophy after intralesional injection of triamcinolone acetonide has been reported in the literature as a very rare side effect. A 30-year-old woman visited our dermatology department for a linear hypopigmented patch with atrophy from her left foot to the lower margin of the knee. The lesion developed after injection of an intralesional corticosteroid. The patient was diagnosed with linear hypopigmentation and atrophy secondary to the triamcinolone injection.     

[Translated article] Dactylitis Due to Subcutaneous Sarcoidosis as a Manifestation of Sarcoidosis

Dactylitis, or sausage fingers or toes, refers to the swelling of 1 or more digits. Sarcoid dactylitis is an uncommon form that tends to be caused by granulomatous bone involvement in the underlying phalanges. Sarcoid dactylitis can, however, clinically resemble subcutaneous sarcoidosis with finger or toe involvement. We describe 5 patients with dactylitis due to subcutaneous sarcoidosis of the fingers. In all cases, the proximal phalanges were involved; sarcoid dactylitis, by contrast, tends to affect the medial and distal phalanges. Differential diagnosis is important, as dactylitis due to bone involvement tends to be much more persistent and is generally seen in chronic forms of sarcoidosis.     

硫酸羟氯喹治疗盘状红斑狼疮的分析

观察硫酸羟氯喹HCQ治疗盘状红斑狼疮DLE的疗效并分析其副作用。结果:49例DLE病人的体征与治疗前相比差异有显著意义P<0.01,总有效率75.5%。不良反应较轻。     

1型神经纤维瘤病伴大脑萎缩1例

患者女,19岁,躯干、四肢多发褐色斑片、肿物10余年,伴左腕部内翻畸形,癫痫发作及智力低下.皮肤科情况:躯干、四肢见大小不等褐色斑片,直径约数毫米至10 cm不等,另见多个大小不等皮色至淡红色肿物,直径约1～15 cm不等,肿物质软,界清,无触痛.头颅CT示:右侧大脑萎缩.皮肤肿物组织病理示:真皮见淡染瘤体,内见多数核...     

Scar Sarcoidosis: A Retrospective Investigation into Its Peculiar Clinicopathologic Presentation

BackgroundScar sarcoidosis (SS), a rare form of cutaneous sarcoidosis, develops from pre-existing scars. Owing to its rarity, the clinicopathologic features and its significance in clinical prognosis have been obscure.ObjectiveThis study aimed to investigate clinical, laboratory and histopathologic findings and to clarify characteristics associated with the development of SS and systemic involvement.MethodsWe retrospectively assessed clinical, laboratory and histopathologic findings of SS. Clinical factors including demographics, anatomic area, number of lesion (single, multiple), presence of symptoms, latent period, injury types related to scar and the proportion of systemic involvement were investigated.ResultsOf the 21 patients with SS, skin lesions appeared predominantly in females (85.7%) and in the head and neck (57.1%). The mean latent period was 163.5 months and 13 patients (61.9%) had multiple lesions. Injury types were varied, with no specific type identified as associated with SS. Histologically, discrete sarcoidal granulomas surrounded by densely packed collagen bundles with a thickening of numerous fibers were observed. Ten patients (47.6%) had systemic involvement and showed significantly more of the multiple lesions, longer latent period and higher level of mean serum angiotensin-converting enzyme than those without systemic involvement.ConclusionVarious causes of scar were related to SS, but no specific injury type was identified as leading to SS. Although the exact pathomechanism remains unclear, the possibility of systemic involvement could be considered when the patients have multiple lesions, longstanding scars, and elevated serum angiotensin-converting enzyme.     

皮下结节病

皮下结节病是一种少见的结节病皮肤损害,病因不明,免疫反应是主要发病机制。临床表现为四肢的无痛性皮下结节,多伴有双侧肺门淋巴结肿大等系统损害。组织病理表现为皮下脂肪层和真皮深层的非干酪性上皮细胞样结节,周围有结缔组织包裹,结节周围少量淋巴细胞浸润。结合组织病理检查和影像学检查可明确诊断。糖皮质激素是首选治疗方法。肿瘤坏死因子-α拮抗剂、免疫抑制剂和光动力治疗也是可供选择的治疗手段之一。     

白色萎缩1例

报告白色萎缩１例。女性，２６岁，双下肢反复起皮疹溃疡１３年。检查：双下肢象牙白色萎缩性白斑，周围有毛细血管扩张，紫癜。病理示真皮浅层血管壁纤维蛋白样物质沉积及血管周围淋巴细胞浸润，直接免疫荧光示真皮浅层、小血管壁ＩｇＧ、ＩｇＭ、Ｃ３沉积。用低分子右旋糖酐及复方丹参静滴后皮损消退，随访６周无复发。对此病的病因、分类及治疗进行了讨论。     

Successful Treatment of Hydroxychloroquine-Induced Recalcitrant Acute Generalized Exanthematous Pustulosis with Cyclosporine: Case Report and Literature Review

Acute generalized exanthematous pustulosis (AGEP) is a cutaneous reaction principally induced by drugs. Spontaneous resolution is observed in most patients. However, severe cases required systemic corticosteroid administration. Hydroxychloroquine, which is used to treat some dermatologic and rheumatologic diseases because of its anti-inflammatory and immunosuppressive effects, is an uncommon cause of AGEP. A 67-year-old female patient presented with severe AGEP due to hydroxychloroquine treatment. She was recalcitrant to supportive care and systemic corticosteroid treatment butwas successfully treated with cyclosporine. Hydroxychloroquine-induced AGEP occurs in women with underlying rheumatologic diseases, has a longer latent period, and has a severe course usually requiring systemic treatment.     

Aneurysmal Benign Fibrous Histiocytoma with Atrophic Features

Aneurysmal benign fibrous histiocytoma is an uncommon pathologic variant of dermatofibroma. In addition to the features of a typical dermatofibroma, it has large cleft-like or cavernous blood-filled spaces with numerous hemosiderin pigments. It should be differentiated from angiomatoid malignant fibrous histiocytoma, malignant melanoma, and vascular tumors such as Kaposi''s sarcoma and angiosarcoma. Atrophic dermatofibroma is also a rare variant of dermatofibroma, and the combination of aneurysmal and atrophic features is rarer still. We report a case of aneurysmal benign fibrous histiocytoma with atrophic features in a 27-year-old male who had a grayish-brown atrophic patchy lesion on his back for 2 years.     

皮下结节病

皮下结节病是一种少见的结节病皮肤损害,病因不明,免疫反应是主要发病机制.临床表现为四肢的无痛性皮下结节,多伴有双侧肺门淋巴结肿大等系统损害.组织病理表现为皮下脂肪层和真皮深层的非干酪性上皮细胞样结节,周围有结缔组织包裹,结节周围少量淋巴细胞浸润.结合组织病理检查和影像学检查可明确诊断.糖皮质激素是首选治疗方法.肿瘤坏死因子-α拮抗剂、免疫抑制剂和光动力治疗也是可供选择的治疗手段之一.     

瘢痕性结节病国内首报

患者女,54岁。５年前出现全身乏力,双膝关节肿痛,体质量下降。就诊半年前于左眉外侧陈旧瘢痕处出现一硬结。皮疹先后累及躯干和四肢,特别是手部原有陈旧瘢痕处均出现红斑,结节。体检：双腋下淋巴结肿大。左眉外侧一斑块,位于原有瘢痕处。右上臂伸侧可及一皮下肿块,左手瘢痕处和双足底可见多个暗红色结节。左侧前臂及躯干少许散在的红色小丘疹。血清血管紧张素转化酶82 kU/L。CT示两肺散在多发模糊小结节灶,纵隔及腋下多发肿大淋巴结影,双侧肺门淋巴结未肿大。组织病理符合结节病。予甲泼尼龙口服后皮损明显好转。本例皮损同时具有瘢痕、结节、斑块、皮下肿块和丘疹,较为少见。对原有的陈旧性瘢痕出现活动,表现为红肿、结节,是诊断结节病的重要线索。     

Antipalúdicos en dermatología: mecanismo de acción,indicaciones y efectos secundarios

Antimalarial drugs have been in common use in dermatology since the 1950s. Their mechanism of action is complex, and it is now known that they act through various pathways. We review the indications for antimalarials in dermatology, their adverse effects, and some less well-known effects, such as their antithrombotic and hypolipidemic action. The most recent recommendations concerning ophthalmological screening in patients on antimalarials are also reviewed.     

NB-UVB及羟氯喹和糖皮质激素三联疗法治疗泛发性扁平苔藓1例

患者男,57岁。口腔溃烂、手足及躯干起疹1月余。背部皮损组织病理可见胶样小体,诊断:泛发性扁平苔藓。予NB-UVB联合糖皮质激素口服及羟氯喹治疗,8周后皮疹消退。