遗传性泛发性色素异常症1例

报告1例遗传性泛发性色素异常症的17岁男性患者，母亲左下腹有局部色素异常的表现。患者全身泛发色素沉着斑间以色素减退班，局部呈网状外观。HE染色示色素沉着区基底层细胞中黑色素增加，色素减退区黑素减少或缺如，而黑素细胞并不减少。人黑素细胞抗原HMB-45免疫组化示色素沉着区黑素细胞胞浆内有致密的阳性颗粒，而色素减退区黑素细胞胞浆内阳性颗粒少见。     

Q开关激光多疗程治疗太田痣无效二例

报道2例激光治疗多次无效的太田痣.患者均为女性,均在出生后数月发病,累及左侧面部,皮损表现为颧部、面颊部灰褐色至褐青色斑片,巩膜无蓝染.1例怀孕期斑片扩展至左耳后及左颈后.组织病理显示真皮深层及皮下脂肪组织间散在分布黑素细胞及噬黑素细胞,胶原纤维明显增生.免疫组化CD34标记血管内皮细胞分布无异常.对一般用于太田痣的激光治疗反应差.Q开关翠绿宝石激光(波长755 nm)和或Q开关Nd:YAG激光(波长1064 nm)累计治疗10余次几乎无效(1例治疗12次,1例治疗13次),且激光即刻反应特殊,即使高能量多次重复照射,皮疹处均无紫癜或渗血,而周围正常皮肤较低能量下即可见明显的紫癜和渗血.     

白癜风皮损黑素细胞HMB-45、酪氨酸酶及其相关蛋白1的免疫组化研究

目的:研究白癜风白斑处黑素细胞分布及酪氨酸酶(TYR)等标记分子的表达情况。方法:对吸疱法所取白斑皮肤以免疫组化染色识别TYR、酪氨酸酶相关蛋白1(TRP1)和HMB-45,以Mias99彩色图像分析软件定量图像分析阳性表达的强弱。结果:白斑处黑素细胞数目明显低于正常对照(P<0.01),患者非皮损处与正常人皮肤比较差异无显著性(P>0.05)。皮损处黑素细胞树突减少,平均为3.4个,低于对照组(P<0.05)。残留黑素细胞各抗体呈强阳性染色。白斑毛囊之间可见黑素细胞散在、呈围管样分布。白斑处阳性细胞HMB-45图像灰度值低于正常着色皮肤(P<0.05),而TRP1高于正常皮肤(P<0.01),TYR与正常皮肤无差异(P>0.05)。结论:白斑处仍然有黑素细胞。残存黑素细胞树突回缩、数目变少,而且黑素细胞中黑素细胞标记分子表达异常。     

太田痣及诊疗进展

太田痣是发生于巩膜及同侧三叉神经眼、上颌支分布区域的灰色或蓝色斑片,被认为是黑素细胞从神经嵴向真表皮交界处迁移过程中受阻而停滞在真皮所致。组织病理表现为真皮上部或/和网状真皮散在树突状或梭形黑素细胞,并可见黑素颗粒。临床上通常需要与伊藤痣、蒙古斑和获得性太田痣等相鉴别。大多数太田痣患者可以应用Q开关短脉宽激光(红宝石激光、紫翠玉宝石激光和Nd:YAG激光)成功治疗,而近年来出现的皮秒激光给少数治疗处于"平台期"的患者带来新的希望。     

颧部褐青色痣黑素细胞特性及来源的研究

目的为了进一步证实颧部褐青色痣的组织病理特点,并初步探讨颧部褐青色痣黑素细胞的来源。方法选取颧部褐青色痣、皮内痣、蓝痣及黑变病标本各10例,所有病理切片标本均进行HE染色和免疫组化法检测CD68、S-100、Melan-A、NSE、C-Kit(CD117)在黑素细胞上的表达。结果①颧部褐青色痣的HE染色:在真皮浅层有散在的含黑素颗粒的梭形细胞分布,其细胞长轴与表皮平行,主要分布于真皮浅层。真皮含黑素颗粒细胞分为散在或弥漫的分布。②免疫组化:颧部褐青色痣、皮内痣和蓝痣各组中银染色、S-100、Melan-A、NSE、CD68免疫组化均为阳性,其中Melan-A染色在颧部褐青色痣和皮内痣组显示有表皮基底层黑素细胞增加;黑变病组仅有CD68阳性。C-kit阳性在颧部褐青色痣组有9例、蓝痣组有8例、皮内痣组有5例。结论颧部褐青色痣的表皮基底黑素细胞增加,真皮内既有黑素细胞,也有噬黑素细胞。其黑素细胞是一种具有痣细胞、神经嵴来源细胞及早期胚胎细胞的特性。     

糖皮质激素局部封闭致色素减退中黑素细胞数量及功能的变化

目的探讨糖皮质激素局部封闭(以下简称局封)致色素减退的黑素细胞数量及功能的改变。方法回顾性分析本院确诊的12例局封致色素减退患者的临床及组织病理学特点,4例白癜风患者作为对照,所有病例均行MART-1和Masson-Fontana染色。结果研究组12例,MART-1染色显示黑素细胞形态完整、数量大致正常,仅3例呈轻度减少。Masson-Fontana染色显示黑素颗粒重度减少或消失。对照组4例,MART-1染色显示黑素细胞明显减少或消失,Masson-Fontana染色显示黑素颗粒明显减少或消失。结论糖皮质激素局部封闭致色素减退表现为黑素细胞数量正常,但功能受损,与白癜风患者皮损处黑素细胞变化不同。     

调QAlexandrite激光对太田痣黑素细胞作用机制的研究

目的 研究调Ｑ Ａｌｅｘａｎｄｒｉｔｅ激光对太田痣黑素细胞的作用机制。方法 在激光照射前及照射后各个阶段,对４例患者分别进行１１例次组织病理学观察和１４例次透射电镜观察。结果激光照射瞬间,真皮黑素细胞破坏,黑素小体空泡化,真皮中形成圆形人泡。表皮无明显损伤。     

色素障碍性皮肤病

20 0 4 0 336　白癜风皮损黑素细胞 HMB- 45、酪氨酸酶及其相关蛋白 1的免疫组化研究 /谭诚 (南京医大一附院皮肤科 )…∥临床皮肤科杂志 .- 2 0 0 3,32(7) .- 376～ 378对吸疱法所取白斑皮肤以免疫组化染色识别TYR、酪氨酸酶相关蛋白 1和 HMB- 45 ,以 Mias99彩色图像分析软件定量图像分析阳性表达的强弱。结果白斑处黑素细胞数目明显低于正常对照(P<0 .0 1) ,患者非皮损处与正常人皮肤比较差异无显著性 (P >0 .0 5 )。皮损处黑素细胞树突减少 ,平均为 3.4个 ,低于对照组 (P <0 .0 5 )。残留黑素细胞各抗体呈强阳性染色。白斑毛囊之间…     

白癜风相关黑素细胞膜抗原VIT150、VIT90、VIT75纯化及分析

目的：纯化和分析白癜风相关的黑素细胞膜抗原，为蛋白质微量测序及筛选、克隆黑素细胞膜抗原打下基础。方法：培养高纯度的正常人黑素细胞，活细胞ELISA法和蛋白免疫印迹法(Western blot)检测并筛选抗黑素细胞的高滴度IgG抗体血清，生物素标记可溶性黑素细胞膜抗原，加入筛选血清与蛋白A-琼脂糖凝胶(protein A-sepharose)进行免疫共沉淀．沉淀后的抗原抗体复合物行平极电泳及电转印，碱性磷酸酶标记的亲合素进行化学发光法检测及鉴定。结果：活细胞ELISA法和Western blot检测结果中共筛选了10例白癜风患者高滴度IgG血清，免疫沉淀、免疫印迹、化学发光法检测后发现10例患者均有阳性条带，其抗原相对分子质量为150000、90000、75000、60000。结论：白癜风患者血清中存在抗黑素细胞膜抗原的自身抗体，抗原相对分子质量主要为150000、90000、75000，通过免疫共沉淀初步纯化了150000、90000和75000抗原。     

人黑素细胞培养最佳条件的选择和生物学鉴定

观察人黑素细胞分离培养的最佳条件，为研究色素性疾病奠定基础。采用改良的胰蛋白酶消化法培养黑素细胞；用多巴染色、Fontana银染、S-100免疫组化染色鉴定黑素细胞；用透射电镜观察黑素细胞超微结构。用改良的黑素细胞培养法，可得到较多的黑素细胞，未见成纤维细胞、角质形成细胞污染，鉴定结果表明为黑素细胞。超微结构显示黑素细胞内与合成功能有关的细胞器非常丰富。采用改良的胰蛋白酶消化法分离表皮和真皮，用MCDB153培养液，添加适当浓度的生长因子，能在体外成功地培养黑素细胞，且方法简单，成功率高。     

颧部褐青色痣与性激素相关性的研究

目的:探讨颧部褐青色痣（NFZ）患者血清性激素水平及皮损性激素受体与NFZ发病的相关性。方法: 采用免疫组化法检测雌激素受体（ER）、孕激素受体（PR）及雄激素受体（AR）在10例NFZ及蓝痣石蜡标本上的表达,同时对30例女性NFZ患者采用放射免疫法检测血清性激素（FSH 、P、 E2 、T、LH 及PRL）的水平,并将其结果与健康女性血清性激素水平加以比较。结果:NFZ皮损真皮黑素细胞免疫组化染色有5例AR阳性,ER和PR均为阴性,NFZ患者与健康人比较,血清E2、P、T、FSH、LH、PRL差异无显著性（p>0.05）。结论:NFZ的发病与性激素E2、P、T、FSH、LH、PRL水平无关,但其黑素细胞有雄激素受体。     

Successful treatment of a patient with multicolored nevus of Ota using a combination of 1064 and 532 nm Q-switched Nd:YAG lasers

ABSTRACT

Nevus of Ota (NO) is a hamartoma of dermal melanocytes usually presents as unilateral blue, gray or brown macules or patches. It can impose a high burden of cosmetic and psychological disturbances in affected individuals. Q-Switched lasers appear to be an effective treatment for this kind of dermal melanocytosis. Multicolored Ota nevus is a rare variant of this kind of nevus and its treatment may be more challenging compared with unicolor lesions. Herein we report a 21-year-old woman with a multicolored nevus of Ota (blue and brown), which showed a dramatic response to a combination of 1,064 nm and 532 nm Q-Switched Nd:YAG lasers. We also discuss different aspects of the Q-switched laser application of Ota nevus treatment. We also focus on laser combination therapy to treat the nevus of Ota.     

Congenital Dermal Melanocytosis on the Foot: A Case Report and Review of the Literature

Dermal melanocytosis is a common pigmented skin disease, characterized by an increased number of ectopic melanocytes in the dermis. Rare variants of dermal melanocytosis that do not belong to these four typical groups–nevus of Ota, nevus of Ito, blue nevus, and Mongolian spots–are called dermal melanocyte hamartoma, or congenital dermal melanocytosis (CDM) as it mostly appears from birth. We report a case of CDM on the foot of a young woman with a literature review of previously reported cases of CDM.     

Nevus of Ota and choroid melanoma

A 59-year-old patient presented with metastatic uveal melanoma that developed in a nevus of Ota. The nevus of Ota or oculodermal melanocytosis contains an increased number of dermal melanocytes in the distribution of the ophthalmic and maxillary divisions of the trigeminal nerve. Malignant transformation arising in a nevus of Ota may occur in all anatomical sites influenced by the nevus. Most often the choroid is involved. Although the nevus of Ota is rare in Caucasians, associated melanoma is more common than in Asians or black people. The dermatologist should be aware of this problem and aim at an interdisciplinary management of these patients.     

Congenital segmental dermal melanocytosis in an adult.

BACKGROUND--Dermal melanocytosis is characterized by the presence of melanocytes in the dermis. There are several morphologic forms, such as the blue nevus, the mongolian spot, the nevus of Ota, and the nevus of Ito. In this article, we report an unusual case of dermal melanocytosis. OBSERVATIONS--A 28-year-old white woman was referred to us, as she had an extensive, speckled gray-blue pigmentation on the right aspect of her trunk that was in a segmental pattern. The lesion had been present at birth. Histologic and ultrastructural examinations revealed sparse, elongated dermal melanocytes. CONCLUSIONS--We comment on the differential diagnosis with classic recognized forms of dermal melanocytosis. We also review other isolated cases of unusual dermal melanocytosis. This is a distinct case, clinically different from previously reported cases in the literature; we propose the term "congenital segmental dermal melanocytosis" to name this case.     

Unilateral Nevus of Ota with Bilateral Nevus of Ito and Palatal Lesion: A Case Report with a Proposed Clinical Modification of Tanino's Classification

Nevus of Ota and nevus of Ito are rare dermal melanocytoses. Nevus of Ota may be very rarely associated with the nevus of Ito and other extra cutaneous features. Both nevi are similar in all respect apart from the area of distribution. Bilateral distribution of nevus of Ito is seldom reported in the literature. A 24-year-old male patient reported with nevus of Ota of the right side of his face since his infancy and nevus of Ito on both shoulder regions since early childhood. He had bluish lesions on the right side of his hard palate. Systemic examination was normal. Relevant laboratory investigations were non contributory. The histopathological examination of the skin from the affected areas showed the presence of elongated dendritic dermal melanocytes. The present case is the first report of an association of bilateral nevus of Ito with nevus of Ota and palatal lesions. Tanino classified Nevus of Ota into four groups. As both the nevi are similar in all respect except the area of distribution, a minor modification of the existing Tanino''s classification to incorporate the nevus of Ito into the classification for the Ota''s nevus may be appropriate.     

An Unusual Case of Congenital Dermal Melanocytosis

Dermal melanocytosis is characterized by the presence of ectopic melanocytes in the dermis. The most common forms include the Mongolian spot, blue nevus, nevus of Ota, and nevus of Ito. Some types of dermal melanocytosis do not fit into any of these morphologic categories, however. Our case demonstrated an extensive amount of uniform deep blue patches of nevi with unilateral distribution on the left face, neck, chest, shoulder, and back. On histopathologic examination, a number of elongated melanocytes scattered throughout the dermis were found. We herein report a case of congenital unilateral dermal melanocytosis.     

Clinically distinct form of acquired dermal melanocytosis with review of published work

Dermal melanocytosis is most commonly found in the skin of Asians and other darkly pigmented people. It is histologically characterized by the presence of dermal melanocytes, with or without presence of dermal melanophages. Mongolian spot, nevus of Ito, nevus of Ota, nevus of Hori, and blue nevus are most common and represent distinct types of dermal melanocytosis. Other clinical patterns of acquired dermal melanocytosis have also been described. Herein, we report a unique case of acquired dermal melanocytosis diffusely affecting the entire back of a 50-year old African-American male and also review and discuss various patterns of unusual acquired dermal melanocytosis.