皮肤垢着病1例

报道1例皮肤垢着病，患者女，19岁，双面颊出现垢样物，无明显自觉症状2个月，皮肤科检查见双面颊不规则斑块，附黄褐色油腻性痂，取鳞屑真菌直接镜检发现圆形孢子，给予伊曲康唑治疗取得良效。     

皮肤转移癌

报告1例卵巢癌皮肤转移。患者女,61岁。临床表现为右侧躯干部红斑、斑块、结节伴痒痛1个月余,皮损呈增大趋势,部分可见橘皮样外观。皮损组织病理学检查表现为真皮内见多数大小不一的瘤细胞团块,由上皮样瘤细胞构成,核圆形或椭圆形,细胞异形,部分瘤细胞形成腺腔。诊断为皮肤转移癌。     

淋巴管型孢子丝菌病:一少见的双侧分布的病例

患者,男,79岁。双下肢皮肤多发性损害2月余,局部无外伤史。皮肤检查:双下肢后中部呈线状排列的多发性红斑样结节,中央有溃疡,双侧腹股沟淋巴结肿。实验室常规检查正常。皮损的浓液、渗出液及刮片直接真菌学检查阴性。孢子丝菌素皮肤试验阳性,72小时后为7mm的硬结。葡萄糖沙氏培养基25℃呈乳脂状菌落,表面有皱褶,中央呈褐色。考虑为申克孢子丝菌,镜检为真菌,37℃转为酵母相。皮损     

Ⅰ型先天性皮肤再生不良3例并文献复习

例1女,出生时头顶旋涡旁圆形皮肤缺损,表面有透明薄膜,光滑似水疱,皮损周围发红;3个月后随访,创面呈略红色菲薄纸样瘢痕愈合,触之有囊样感。例2男,例3女,出生时均于头顶旋涡中央出现椭圆形皮肤缺损,表面鲜红色、肉芽肿样,湿润有渗出物;例2于10个月后随访,创面呈肤色膜状瘢痕性愈合,例3于19个月后随访,创面呈灰白色羊皮纸样瘢痕性愈合,质地均柔软。3例瘢痕性愈合处均光滑无毛发。例1诊断为膜性Ⅰ型先天性皮肤再生不良,例2、例3诊断为非膜性Ⅰ型先天性皮肤再生不良。     

婴儿黑点癣1例

 报告1例婴儿黑点癣。患儿女，11个月6天，头皮脓疱、黑点8个月。皮肤科检查：顶部见3片脱发斑，脱发斑内见黄痂，头发在发根处折断，形成黑点，拉发试验阴性。真菌直接镜检可见发内孢子。皮肤镜下可见大量螺旋状发及少量棕黄色痂皮。断发接种于沙保弱培养基25 ℃培养1个月见圆形、紫色绒毛状菌落。诊断：黑点癣。局部使用特比萘芬乳膏，一日两次，1月余后黑点消退。     

双侧乳房皮肤垢着病1例

报告1例双侧乳房皮肤垢着病。患者女,14岁,双侧乳房褐色痂屑伴痒痛2个月。皮肤科检查:双侧乳房见以乳头为中心附着排列的油腻性褐色痂壳及鳞屑,大小不一,刮除痂屑可见正常皮肤。皮损处痂屑真菌镜检见簇集排列孢子。诊断:乳房皮肤垢着病。予盐酸布替萘芬乳膏、紫丙冬青油膏外用,每天早晚各1次,2周后原有皮疹基本消退,未见新发皮疹,刮取局部皮屑行真菌镜检未找到菌丝及孢子。     

氦氖激光治疗口腔固定性药疹的疗效观察

<正> 临床资料男16例,女4例,年龄12～55岁。单纯发生于口腔粘膜者4例,16例伴有皮肤或皮肤粘膜交界处皮损。损害分布于颊粘膜12例,上腭3例,唇3例,口底1例,舌1例,皮肤损害多为圆形或椭圆形红斑,粘膜或皮肤与粘膜交界处则以红斑、水疱、糜烂为主,糜烂面有渗液,     

伊曲康唑治疗孢子丝菌病一例

患者女,44岁。1994年7月21日来我院门诊。主诉半年前被狗咬伤右小腿,伤口一直不愈,并长出一豆粒大结节,嗣后于周围长出同样皮疹,不痒,亦无脓液。在市内某医院皮肤科就诊,一直以湿疹治疗数月,皮肤损害未好转且渐扩大。来我院初诊时体检：右小腿中部外侧皮肤见由米粒至绿豆大丘疹、结节组成的圆形损害。直径约3cm,皮损触之较坚实,少数结节能挤出脓样分泌物,表面有少许脱屑。取脓样分泌物作真菌培养及镜检,证实为申克孢子丝菌。诊断：孢子丝菌病。自1994年8月1日开始口服伊曲康唑200mg/d,共服药三个半月,疗程结束后复查皮肤损害已全部消退,取材培养无真菌生长。随访至今未见复发。服药期间有轻度恶心,不影响     

洁霉素致多形红斑型药疹1例

患者女,31岁。因全身皮肤红斑、水疱伴瘙痒、高热1天入院。10天前因“上呼吸道感染”肌注洁霉素0.6ｇ,日2次。治疗3天病情好转后未再继续用洁霉素。1天前四肢皮肤突然出现红斑、水疱伴瘙痒、高热,皮疹迅速增多遍及全身皮肤及双眼睑。体检:Ｔ39.6℃,神清,急性高热病容。系统检查未见异常。皮肤科情况:全身皮肤可见散在分布、扁豆至指盖大小圆形或椭圆形水肿性红斑,边界清楚,压之退色。部分红斑中央见粟粒至绿豆大小水疱,水疱中央凹陷,疱液澄清呈淡黄色,尼氏征(-),部分水疱破溃糜烂。双侧眼睑可见红肿、糜烂。实验室检查:尿、粪常规及肝功能、…     

麻风的舌损害

选择200名未治的瘤型麻风检查其舌部的损害,其中男164名,女36名;平均病期3.75年,平均BI4.2+。在良好的自然光下检查口腔。结果2例有舌麻风损害(1％)。例一为男性、30岁,病期6年,检查见硬腭中线部有糜烂,舌背中线有5个0.5～1.0cm圆形或椭圆形的白色结节性损害;舌尖隆起部下卷,有一3.5×2.0cm的不规则形白色斑块,间有疤痕和皱襞;舌后三分之一及软腭正常。皮肤和腭活检为瘤型麻风,细菌阳性。舌活检可见上皮增生,上皮下空白带     

Optimizing the cut in Mohs' micrographic surgery in regard to skin sparing and microscopic view: is a round incision cut necessary?

Saucer incision is the common cut in Mohs' micrographic surgery. To date no proof as to the superiority of this cut over other patterns has been presented. In this work we examine the round pattern aspect of the saucer incision and answer two questions: does the round cut provide the best skin‐sparing pattern? And, does it provide the best microscopic view? A two‐dimensional geometric analysis is used to determine whether a round incision is optimal from the standpoint of skin sparing and microscopic view. Mohs' micrographic surgery views are used to back up the geometric hypothesis. The result is that the round incision pattern is skin‐wasteful compared to an incision that follows the cancerous lesion. In the lesion presented here the two cuts have a ratio of 1.5 between the two excised skin areas, indicating a waste of healthy skin of 50%. It is also shown that specimens with a pointed edge provide better layer projection. The conclusion is that a tailored cut following the lesion pattern is the optimal Mohs' incision. Therefore in the first stage of Mohs' micrographic surgery the skin cut should replicate the lesion pattern instead of a round saucer cut. Though many Mohs' surgeons already implement this philosophy, in the literature the saucer incision recommended by Dr Frederic Mohs' remains the norm.     

Congenital Smooth Muscle Hamartoma of the Skin

Abstract: : A 2-month-old white girl had a congenital, tan-colored, slightly elevated, 3 × 2-cm plaque on the left midback. Clinically, the lesion was suspected to be a solitary masiocytoma. Rubbing the lesion produced a transient erythema and edema that was similar to Darier sign seen in mastocytoma. Analysis of a skin biopsy specimen revealed a smooth muscle hamartoma; special stains did not show evidence of increased numbers of mast cells. This relatively uncommon condition can be confused with a variety of other cutaneous diseases. Light microscopic examination of a skin biopsy specimen establishes the diagnosis. A review of the approximately 50 cases reported in the literature showed that there is no known associated systemic involvement or malignant transformation. The clinical lesions usually become less prominent with time.     

疣状皮肤结核患者皮损中结核杆菌DNA的检测

本文采用PCR技术，对10例病史2年以上的疣状皮肤结核患者皮损进行了结核杆菌DNA检测，结果显示10例患者1例阳性，而作为阳性对照的4例淋巴结结核组织3例阳性，2例正常组织均为阴性。从而说明疣状皮肤结核后期组织结核菌极少或无有。     

Rudimentary Meningocele of the Scalp

A rudimentary meningocele, a variant of primary cutaneous meningioma, was seen on the scalp of a 9-month-old Japanese boy. Clinically, the lesion on the left parietal area was round, about 1.6 cm in diameter, alopecic, and slightly elevated. Histologically, the lesion, located from the dermis to the subcutis, consisted of scattered foci of meningothelial cells, an anastomosing network of empty spaces with psammoma bodies and collagen bodies, and small vessels. Immunohistochemically, the meningothelial cells were positive for vimentin and desmin. Ultrastructurally, they had elongated cytoplasmic processes, intermediate filaments in the cytoplasm, and desmosomal junctions.     

Nevus lipomatosus cutaneous superficialis with perifollicular fibrosis

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare hamartomatous skin lesion histopathologically characterized by the presence of mature fat tissue even within the upper dermis. Clinically, two types of NLCS can be distinguished; a multiple type and a solitary type. We here report a 10-month-old girl showing multiple type NLCS as a collection of a nodule and papules on her right abdomen. Histological examination revealed that the lesion was composed of a lobular proliferation of fat tissue throughout the dermis and immature hair follicle-like structures with perifollicular fibrosis. Histological alterations of the dermal connective tissue components were also seen, including thickening of collagen bundles and increased numbers of both fibroblasts and blood vessels. This is the first reported case of NLCS with perifollicular fibrosis.     

Giant orf on the nose

Ecthyma contagiosum, or orf, is a viral zoonosis of sheep and goats that can be transmitted to humans. In humans, it generally manifests as a solitary skin lesion, although rarely it can have an unusual course or be accompanied by systemic symptoms or complications. We present a case of giant orf lesion on the nose of a 9-year-old. The lesion grew rapidly and measured 5 cm by 4 cm and was attached to the right ala nasi by a base 2 cm round in diameter. The diagnosis was suggested by clinical and histopathologic appearance and confirmed by electron microscopic visualization of the virus. The lesion resolved spontaneously with minimal scarring and the entire cycle lasted about 3 months.     

Melanoma with prominent pigment synthesis (animal-type melanoma): a case report with ultrastructural studies

Melanoma with prominent pigment synthesis or animal-type melanoma (ATM) is a very rare type of melanoma. Its histogenesis has not been elucidated and ultrastructural features have not been described in human beings. We present an additional case of ATM in a 28-year-old woman with positive sentinel node biopsy and provide the results of electron microscopic studies. Histopathologically, the skin lesion was composed of heavily pigmented neoplastic cells mostly arranged as large sheets, focally also in a nodular growth pattern. After bleaching, the neoplastic cells demonstrated round nuclei with 1 or rarely 2 conspicuous nucleoli and a prominent nuclear membrane and abundant, gray, slate-like cytoplasm. Some cells demonstrated round cytoplasmic inclusions. There was no nuclear pleomorphism, and only a few mitotic figures could be found after extensive search. Multiple areas of necrosis en masse of tumor cells were seen. The lymph node biopsy revealed a complete effacement of the lymph node architecture by the extensive proliferation of hyperpigmented cells in the parenchyma. Immunohistochemically, the same pattern of staining was seen on the bleached and unbleached slides both in the skin and in the lymph node. The neoplastic cells stained positively with MiTF (nuclei), NSE, NKI/C3, tyrosinase (weak), p53, and CD68. S-100 protein, HMB45, Melan A, Mac367, and lysozyme reacted negatively. Occasional cells (<1%) reacted with MIB-1. Ultra-structural studies revealed that the neoplastic cells possessed a large, indented nucleus with a prominent nuclear membrane, a single (para) centrally located nucleolus, and peripherally marginated chromatin. The cytoplasm was abundant and contained numerous single melanosomes and rare compound melanosomes. The melanosomes were in stages II to IV of maturation, with a marked predominance of stage II and stage III melanosomes. There was a high number of aberrant melanosomes with a wide variety of configurations. Melanophages were a minor component of the lesion. Our ultrastructural studies provide unequivocal evidence that ATM is a neoplasm of melanosome-producing cells. We also review the literature on ATM.     

Subcutaneous Myxoid and Round Cell Liposarcoma

Myxoid and round cell liposarcoma is a variant of liposarcoma characterized by a morphologic continuum in which tumor progression from low-grade myxoid to high-grade hypercellular or round cell areas may be observed. A 28-year old man presented with a painful skin colored subcutaneous mass on his left flank. The skin lesion was discovered about two months ago. Computed tomography revealed a well-defined tumor in the subcutaneous area without significant lymphadenopathy. A histopathologic study showed a nonencapsulated nodular growing tumor mass under the deep dermis composed of a mixture of atypical proliferating lipoblasts in a prominent myxoid stroma, occasional uniform round to oval shaped primitive nonlipogenic mesenchymal cells and plexiform, chicken wire shaped capillaries. Based on these findings, we diagnosed this case as myxoid and round cell liposarcoma. Because liposarcomas are large tumors of the deep subcutis or deeper soft tissue, they rarely come to the attention of the dermatologist. However, liposarcoma should be of concern, especially when rapid growing subcutaneous tumors are shown.     

婴儿头皮前B淋巴母细胞性淋巴瘤

报道1例婴儿头皮前B淋巴母细胞性淋巴瘤。患儿男,9个月,因头皮肿块,脱发6个月余就诊。皮损表现为7．5cm×10．5cm浸润性肿块,呈暗红色,形态不规则,皮损区头发稀疏伴斑状脱发。皮肤活检示真皮及皮下组织弥漫性分布肿瘤细胞,瘤细胞中等大小,胞质少,核呈圆或卵圆形,核仁小,可见核分裂相,表真皮之间有细胞浸润带将表真皮分开。免疫组化CD20、BCL-2、Ki-67和PAX5均呈阳性表达,CD3、TdT、CD30、AI。K、CK5／6、CD56、TIA-1、CD43、CD117、穿孔素和颗粒酶B为阴性。     

UNUSUAL MANIFESTATION OF DEMODICIDOSIS IN A CHILD

A 14-month-old male infant was brought to the Department of Dermatology, Yonsei University Wonju College of Medicine, with a scaly pruritic skin rash on the glabella area that had been present for 3 weeks. Physical examination showed a coin-sized erythematous scaly patch on the glabella (Fig. 1). There had been no response to the application of topical corticosteroid (Vaspit). The medical history and the results of physical examination were otherwise unremarkable. The diagnosis at the time was atopic dermatitis. A fungal study to rule out tinea faciei showed no fungal spores or hyphae, but many scattered Demodex mites ( D. foiiicuiorum ) were seen in a 10% potassium hydroxide preparation of skin scrapings (Fig. 2). The patient's lesion cleared with the appli-cation of crotamiton cream on three consecutive nights.