768例黑素细胞痣及类似可疑损害切除活检的回顾性分析

目的：了解黑素细胞痣诊断准确性，病理特征，去除方法及复发等问题。方法：回顾分析我院1990年－2000年诊断或疑诊黑素细胞痣的768例活检病理资料，结果：诊断为黑素细胞痣447例，疑诊为黑素细胞痣296例，黑素细胞痣恶变待排25例，共有30例（3．91％）病理诊断为恶性肿瘤，其中恶性黑素瘤6例（0．78％），基底细胞癌22例（2．86％），Bowen病2例（0．26％），结论：黑素细胞痣的诊断应予重视，在有疑问时，手术切除并做病理检查十分必要。     

间接免疫荧光检测晕痣抗黑素细胞抗体

间接免疫荧光检测晕痣抗黑素细胞抗体姜国调，王洪琛，邵燕玲北京协和医院皮肤科（邮政编码１００７３０）我们采用间接免疫荧光技术，对１９８７～１９８８年间２０例晕痣病人血清中抗黑素细胞抗体进行检测，旨在探讨晕痣的发病机理．结果这些病人的血清中未见抗黑素细胞...     

巨大先天性黑素细胞痣1例

先天性黑素细胞痣（congenital melanocytic nevus,CMN）虽然出生时即有，但无遗传性，其走私较后天性黑素细胞痣大，直径＞20cm者则称为巨大先天性黑素细胞痣。现将我科诊治的1例头皮巨大先天性黑素细胞痣报告如下。     

《临床药物变态反应诊断与处理》正式出版

色素血管性斑痣性错构瘤病（phakomatosis pigmcntoyaseularis）主要牲是皮肤血管瘤（主要为鲜红离不开痣）伴黑素细胞痣或表皮痣，较少见。2002年我科报道了1例，现将所见的另1例报道如下。     

多发性簇发型斯皮茨痣

斯皮茨(Spitz)痣是一种来源于黑素细胞的后天性良性肿瘤,又称为梭形或上皮样细胞痣(spindle cell or epithelioid cellnevus)、良性幼年性黑素瘤.本病多见于儿童和青少年,好发于面部及四肢.皮损多为单发,但也可多发.多发性皮损临床少见,现将我科诊治的1 例多发性簇发型Spitz 痣报告如下.     

电离子治疗面部色痣的疗效与安全性观察

色痣,又称痣细胞痣,发生于面部者,无消退趋势,影响美观。为了探求治疗面部色痣的方法和效果,以满足众多爱美者的美容需要,本所于2004年7月~2005年6月对108例面部色痣患者采用GX-III型多功能电离子手术治疗仪(广西科学院应用物理研究所生产)治疗观察,取得满意疗效。现报道如下:1     

微波治疗面部色素痣75例

色素痣为痣细胞痣中的交界痣,有恶变可能,但概率较低。临床上对于没有恶变趋向的色素痣一般不需要治疗。但长在颜面部位者,因有碍美容,要求祛除者日渐增多。有的患者轻信“药物取痣”的方法,使用有强烈腐蚀作用的某些化学物质,致使皮肤灼伤。因而到皮肤科要求取痣者日渐增多。为了探求治疗面部色素痣的方法和效果,满足众多爱美者的美容需求,我们自2006年1月至2006年12月对75例面部色素痣患者采用微波综合治疗仪(CR2001型,成都维信电子科大新技术有限公司生产)治疗观察,取得满意疗效,现报道如下:1临床资料与方法1.1病例选择标准(1)男女不限,…     

发育不良性痣11例临床病理学分析

目的 探讨发育不良性痣的临床病理学特点。方法 对11例临床表现为色素性损害的手术标本行H-E染色，结合临床指标及评分进行研究和分析。结果 临床表现：皮损直径≥5mm者8例，多发性损害者7例，边界模糊者4例，外形不规则者6例，痣表面色素不匀者4例，基底色红者6例。光镜下：交界痣3例，复合痣8例。发育不良性痣较为特异的组织学表现为真表皮交界处雀斑样增生，痣细胞巢增生紊乱倾向于形成“桥型”融合。表皮下方的非典型黑素细胞在基底层呈“Paget”样蔓延，真表皮交界处的黑素细胞向周围延伸，并超过真皮内的痣细胞成分。非典型黑素细胞：细胞核较角质形成细胞核大，多形性，出现核仁，深染。结论 临床和组织病理相结合是诊断发育不良性痣的可行性标准，仅根据组织学的非典型性不能诊断发育不良性痣。     

巨大先天性黑素细胞痣恶变并淋巴结转移1例

报告1例巨人先天性黑素细胞痣恶变淋巴结转移，患儿男，14个月，出生后即发现腰骶部有巨人黑素细胞痔，14个月时皮损组织病理检查示，黑素细胞痣恶变并有右侧腹股沟淋巴结转移。     

溴化亚铜脉冲激光光动力学疗法治疗鲜红斑痣

我们从１９９２年７月开始用溴化亚铜（ＣｕＢｒ）脉冲激光光动力学疗法（ＰＤＴ）治疗鲜红斑痣８例，２１个区域，疗效满意，现在报告如下。一、临床资料８例鲜红斑痣均经皮肤科或口腔科确诊。男１例，女７例；年龄１１～４４岁，１１岁１例，１３岁１例，２１～３０岁５例，４４岁１例；紫红色５例，粉红色３例；面部１３处，颈部８处；患处面积１０ｃｍ２～１５ｃｍ２２例，５ｃｍ２～１００ｃｍ２２例，２５０ｃｍ２～５５０ｃｍ２４例；红斑连成一片的３例，其余患者红斑都分散成二片以上。其中２例接受过冷冻和铜蒸气激光的烧灼治疗，…     

Evaluation of cosmetic tattooing in localised stable vitiligo

Thirty patients with localised stable vitiligo were selected from the Out Patient Department for cosmetic tattooing. Of them, 19 cases (63.3%) had skin patches, 9 cases (30%) had mucosal patches, and 2 cases (6.7%) had both skin and mucosal involvement. After complete clinical evaluation, cosmetic tattooing was performed on these patients, and they were followed up for 6 months. As results, 23 cases (76.7%) had excellent color matching, 2 cases (6.7%) had good color matching, and 5 cases (16.6%) had pigment shedding. Excellent results were seen in all mucosal patches. Dark complexion cases showed better results than fair complexion ones.     

Photodynamic therapy with 5-aminolaevulinic acid, dimethylsulfoxide and curettage in basal cell carcinoma: a 6-year clinical and histological follow-up

Background   Long-term follow-up data are needed to evaluate treatment effect after photodynamic therapy (PDT).
Objective   To investigate long-term clinical, histological and cosmetic follow-up results in basal cell carcinoma (BCC) after PDT, including treatment response related to patients and lesion characteristics.
Materials and methods   A longitudinal study of 44 patients with 60 histologically verified BCC tumours, treated with one or two sessions of dimethylsulfoxide (DMSO)-supported 5-aminolaevulinic acid – PDT following curettage, was performed. Lesions in complete remission after 3 months were followed with clinical inspection, histological investigation and evaluation of cosmetic outcome at regular intervals; long-term efficacy assessed as verified recurrence within 72 months after PDT.
Results   Complete remission at 3 months was achieved in 55 lesions from 39 patients. Two patients with one lesion each died. At 72 months, 43 of 53 lesions remained disease-free (81%); 68% remained after one treatment session, and 91% remained after two treatment sessions. Recurrence of tumour occurred at 6, 12, 24 and 36 months in 2, 4, 2 and 2 lesions, respectively; clinical investigation identified 97% of them. Male sex and H-mid-face zone were significantly associated with recurrence.
The cosmetic outcome at 72 months was rated as good or excellent by patients and investigators in more than 90% of evaluated cases.
Conclusion   DMSO-PDT following curettage is an effective treatment for BCC, with favourable long-term clinical, histopathological and cosmetic results. Clinical examination of treated lesions appears to be sufficient for long term follow up.     

Secondary intention healing with satisfactory outcome after nodular basal cell carcinoma excision on the face

Secondary intention healing on concave areas of the face may provide acceptable cosmetic outcome after tumor excision but is underused. We evaluated cosmetic outcome and tumor recurrence of this technique in 10 patients with nodular basal cell carcinoma and one patient with basosquamous carcinoma on the face. The average size of these tumors was 1 cm. Subjective evaluations included patients' satisfaction on the degree of wound pain, ease of wound care, and satisfaction with cosmetic outcome. Objective evaluations included physician's scoring on the time to complete wound healing, wound infection, cosmetic outcome, and tumor recurrence after operation. The operations were completed in 30 minutes on average. All wounds healed well without infection within 4 weeks. Postoperation wound pain was absent to mild. Wound care was neither difficult nor troublesome. All patients were satisfied with the cosmetic outcome. Physicians scored good or excellent cosmetic outcome in 91% of patients. No tumor recurred during 3–60 months (median, 13 months) of follow-up. Secondary intention healing appears to be a good option after excision of nodular basal cell carcinomas located on concave areas of the face. Good to excellent cosmetic results can be expected after wound healing.     

Intradermal buried vertical mattress suture as sole skin closure: evaluation of 149 cases

Various buried suture techniques have been reported for dermatological surgery, but in most cases, superficial non-absorbable sutures are placed additionally. The aim of this study was to evaluate whether the intradermal buried vertical mattress suture can be safely used without additional skin suturing. Following 149 procedures in 126 patients, the colour and dehiscence of the scar and the presence of hypertrophy, granulomas or keloids were analysed. The cosmetic results were excellent to good in 78.5%, satisfactory in 19.5% and poor in 2%. Single additional superficial sutures had to be placed in only 14.7%. Suture marks were absent. Hypertrophic scarring was significantly more frequent in scars sutured with polyglactine than in scars sutured with polydioxanone. Early wound dehiscence, secondary wound healing and infection due to missing superficial skin sutures did not occur. This suture technique is safe, easy and fast to perform, and achieves good cosmetic results without leaving suture marks.     

CO2点阵激光联合5-氨基酮戊酸光动力疗法治疗面部光线性角化病的疗效观察

 目的 观察CO₂点阵激光联合5-氨基酮戊酸光动力疗法（ALA-PDT）治疗面部光线性角化病的临床疗效与安全性。方法 采用开放性、非对照性临床研究,对15例面部光线性角化病患者进行CO₂点阵激光联合ALA-PDT治疗,共治疗1~5次,随访1年,观察疗效及安全性。 结果 2例患者经过1次治疗后获得完全缓解,4例2次治疗后完全缓解,9例3～5次治疗后完全缓解,随访12个月均无复发。 3例报告美容效果极好,7例报告美容效果良好,5例报告美容效果一般。治疗过程中,有11例患者轻微疼痛,4例明显疼痛。结论 CO₂点阵激光联合ALA-PDT治疗面部光线性角化病有效,美容效果好。     

The local treatment of the keratoacanthoma with 5-fluorouracil]

In the last two years thirteen patients with keratoacanthomas were treated with 5% f-fluorouracil ointment at the Department of Dermatology II of the University of Vienna. Treatment lasted from two to eight weeks depending upon the size of the tumor. In all cases there was clearing of lesions with good cosmetic results. During an average follow-up period of 7.4 months for all patients there was no recurrence of the tumors.     

Topical methyl aminolaevulinate photodynamic therapy in patients with basal cell carcinoma prone to complications and poor cosmetic outcome with conventional treatment

Background Conventional treatment of basal cell carcinoma (BCC) causes morbidity and/or disfigurement in some patients because of the location (e.g. mid‐face) and size of the lesion. Objectives Following reports that such difficult‐to‐treat BCC lesions have been treated successfully with topical methyl aminolaevulinate (MAL) photodynamic therapy (PDT), a multicentre study was performed to determine the response of such BCC to MAL‐PDT. Methods An open, uncontrolled, prospective, multicentre study was conducted comprising patients with superficial and/or nodular BCC who were at risk of complications, poor cosmetic outcome, disfigurement and/or recurrence using conventional therapy. Patients were given one or two cycles within 3 months of topical MAL‐PDT, each consisting of two treatments 1 week apart. Tumour response was assessed clinically at 3 months after the last PDT, with histological confirmation of all lesions in clinical remission. The cosmetic outcome was rated. Patients with a BCC in remission will be followed up for 5 years for recurrence, of which the 24‐month follow‐up is reported here. Ninety‐four patients with 123 lesions were enrolled and treated with MAL‐PDT at nine European primary care and referral university hospitals. An independent blinded study review board (SRB) retrospectively excluded nine patients and a total of 15 lesions from the efficacy analysis, for not having a difficult‐to‐treat BCC according to the protocol. Results The lesion remission rate at 3 months was 92% (45 of 49) for superficial BCC, 87% (45 of 52) for nodular BCC, and 57% (four of seven) for mixed BCC, as assessed by clinical examination, and 85% (40 of 47), 75% (38 of 51), and 43% (three of seven), respectively, as assessed by histological examination and verified by the SRB. At 24 months after treatment, the overall lesion recurrence rate was 18% (12 of 66). The cosmetic outcome was graded as excellent or good by the investigators in 76% of the cases after 3 months follow‐up, rising to 85% at 12 months follow‐up, and 94% at 24 months follow‐up. Conclusions Topical MAL‐PDT is effective in treating BCC at risk of complications and poor cosmetic outcome using conventional therapy. MAL‐PDT preserves the skin and shows favourable cosmetic results.     

Nevus sebaceus of Jadassohn revisited with reconstruction options

BACKGROUND: Nevus sebaceus of Jadassohn (NS) has the classic presentation on the head and neck of a yellow-orange-colored, waxy, pebble-like, papule or plaque. Its reported malignant potential varies between 0.8% and 50%. The common location of NS on the temporal hairline leaves a cosmetic defect. METHODS: We retrospectively reviewed a consecutive series of patients with NS located in the temporal scalp region. Thirteen patients were included. Twelve patients were reconstructed with a temporal flap. One patient had a primary linear scalp closure after excision. Clinical, histopathologic, surgical, and photographic records were used to review the clinical, anatomic, and pathologic presentation of the lesions. Reconstructions were rated on a scale of 1-5 by two independent examiners. The cosmetic results were also assessed by the patients. RESULTS: Patients ranged in age from 3 to 40 years. All of the lesions were located in the temporal area of the scalp. All cases were pathologically determined as NS. Two cases contained basal cell carcinoma (15%). Two cases were re-excisions of confirmed NS. One case was excised and closed with difficulty using a linear primary closure. Rotation flaps based on the superior temporal artery were used for the reconstruction of the defects in 12 patients. Nine of the flaps were anterior rotation flaps and three were posterior. The average score for the cosmetic results of the patients was 3.75, with the lowest score being 2, and the highest 5. The score for the linear closure was 2. CONCLUSION: A rotation flap based on the superficial temporal artery is an excellent reconstructive solution for NS located in the temporal scalp region.     

The use of second-intention healing for partial-thickness Mohs defects involving the vermilion and/or mucosal surfaces of the lip

BACKGROUND: Partial-thickness defects involving the vermilion and mucosa of the lip are difficult to repair surgically. OBJECTIVE: The purpose of this study was to evaluate the cosmetic and functional effectiveness of second-intention healing in the repair of partial-thickness defects confined predominantly to the vermilion and mucosa of the lip. METHODS: Thirteen patients with squamous cell carcinoma of the lip underwent Mohs micrographic surgery, which resulted in partial-thickness defects predominantly confined to the vermilion and/or mucosa of the lip. All defects were allowed to heal by secondary intention. RESULTS: Twelve patients had good to excellent cosmetic results, and functional impairment was not noted in any of the patients. One patient whose defect extended to the cutaneous portion of the lip had deformation of the vermilion border. CONCLUSIONS: Second-intention healing yields good to excellent cosmetic and functional results for the repair of partial-thickness defects involving the vermilion and/or mucosa of the lip. Defects involving more than 2 mm of the cutaneous lip or defects extending deeper than the superficial portion of the orbicularis oris muscle may result in cosmetic or functional deformity or both if allowed to heal secondarily.     

医用美容胶原注射剂局部注射除皱86例

采用医用美容胶原注射剂局部注射治疗面部皱纹 86例。结果表明 :总有效率达 95 3 5 % ,其中优占43 0 2 % ,良占 5 2 3 3 % ,差占4 65 %。经 6月随访 ,3 6例未吸收 ,3 5例部分吸收 ,15例完全吸收。提示胶原注射安全、简便、易行 ,副作用少 ,短期效果好 ,是面部除皱的新的有效疗法。