播散性浅表汗孔角化病并发寻常性银屑病

报告2例播散性浅表汗孔角化病并发寻常性银屑病.例1.男,53岁.头部、下肢红斑鳞屑3年,环形斑块1年.皮肤科检查:头皮鳞屑性红斑,面部、臀部散在边缘堤状隆起而中央轻度萎缩的褐色环状斑块.例2.男,37岁.全身红斑、鳞屑8年,环形斑块2年.皮肤科检查:头皮鳞屑性红斑,躯干、四肢鳞屑性红斑与边缘堤状隆起而中央轻度萎缩的褐色环状斑块混杂分布,两例患者红斑鳞屑性皮损经组织病理检查均符合寻常性银屑病,褐色环状斑块改变均见下方颗粒层消失的柱状角化不全,符合播散性浅表汗孔角化病.诊断:播散性浅表汗孔角化病并发寻常性银屑病.文中对银屑病并发汗孔角化病的可能原因进行了讨论.     

线状银屑病误诊为线状表皮痣1例

报道1例线状银屑病误诊病例。患儿男,12岁,上下肢条索状红色斑块伴有鳞屑2年。曾于当地医院行病理活检诊断为"炎性线状表皮痣",外用治疗效果不佳。于我院行病理及免疫组化检查,确诊为"线状银屑病",抗银屑病治疗有效。同时分析误诊原因。     

小儿寻常型银屑病伴发皮肌炎1例

患儿男，9岁，头皮、凹肢、躯干部鳞屑性斑块4年。病理报告符合寻常型银屑病，面部水肿性红斑伴肌痛、肌无力2年。肌酶指标升高，肌电图示广泛肌源性损害神经电图示运动神经传导速度在正常范围内。诊断为寻常型银屑病伴发皮肌炎。     

成人银屑病皮炎1例报告及文献复习

报告1例银屑病皮炎。患者男,36岁。因全身反复红斑及丘疹伴瘙痒6年余,加重2个月余就诊。皮肤科检查：头皮可见较多白色鳞屑,枕后可见红色斑块;面部弥漫性红色斑片,上覆白色鳞屑,双耳可见散在痂壳;躯干及四肢散在红色斑块,部分上覆白色鳞屑,指甲部分可见点状凹陷及甲板变形。多次皮损组织病理检查均提示银屑病特征性改变。根据临床表现及皮损组织病理检查结果,最终诊断为银屑病皮炎。     

司库奇尤单抗治疗七例银屑病疗效评价

目的：评价司库奇尤单抗治疗银屑病的疗效和安全性。方法：选取中重度斑块状银屑病患者及泛发性脓疱型银屑病患者,给予司库奇尤单抗,300 mg/次,0～4周每周一次,后每4周一次,并分别于治疗前、1周后、4周后、8周后记录斑块状银屑病患者的银屑病皮损面积和严重度指数(PASI)、泛发性银屑病患者银屑病症状量表(PSS)评分。结果：共治疗6例斑块状银屑病和1例脓疱型银屑病患者,所选的患者均接受至少8周的司库奇尤单抗治疗,起效时间为（1.6±0.73)天;治疗4周时,6例斑块状银屑病患者中全部达到PASI 75,3例达到PASI 90;脓疱型患者PSS评分为2。治疗8周时6例斑块状银屑病患者均达到PASI 100;脓疱型患者PSS评分为0。所有患者治疗期间均未出现严重的药物不良反应。结论：司库奇尤单抗治疗中重度银屑病起效迅速,疗效显著,不良反应少。     

银屑病皮损并发增生性毛鞘瘤一例

<正> 患者男,64岁。全身出现鳞屑性斑块21年、头皮发生新生物4日入院。1968年6月肛周出现鳞屑性斑块,继之头皮出现同样皮疹,入冬泛发全身,诊断为银屑病,经中西医治疗,症状控制,但未痊愈。1988年3     

银屑病停用TNF-α拮抗剂后诱发红皮病一例

患者,男,31岁。全身鳞屑性斑块5年,接受TNF-α拮抗剂治疗8个月后皮疹复发,停药2周后全身泛发红斑、丘疹、鳞屑,伴发热。诊断为红皮病型银屑病,给予IL-17A拮抗剂1周后皮损得到控制。     

儿童色素减退型蕈样肉芽肿1例

<正>患儿男,4岁。躯干出现红色斑块及色素减退斑1个月余。患儿1个月余前无明显诱因胸部、腹部及腹股沟出现密集分布的甲盖至鸡蛋大红色斑块及色素减退斑,边界欠清,表面覆有少许白色鳞屑,无痛痒等不适。当地医院予外用药物治疗（具体不详）后皮损无明显变化。为明确诊断,患儿于2016年6月就诊于武汉市第一医院皮肤科门诊,考虑白癜风？慢性苔藓样糠疹？副银屑病？蕈样肉芽肿？患儿足月顺产,既往体健,家族中无类似疾病患者。体格检查：一般情况良好,各系统检查均正常,浅表淋巴结未触及增大。皮肤科检查：胸、腹部及腹股沟多发圆形、近圆形或不规则的色素减退斑,大小不等,边界欠清,部分白斑表面覆有少许细薄鳞屑;少数皮损中央呈淡红色,周围可见浅白色晕（图1A、B）。Auspitz征（-）。实验室检查：血、尿常规均正常。皮肤鳞屑真菌镜检阴性。     

0.1%糠酸莫米松与5%水杨酸软膏联合与两者单独外用治疗银屑病的疗效及安全性比较

0.1％糠酸莫米松是一种中效、人工合成、不含氟的外用糖皮质类固醇。此药局部治疗中至重度寻常型银屑病安全有效。水杨酸可以软化鳞屑,使之易于剥脱且能增加糖皮质类固醇的透皮吸收,多用于斑块型银屑病患者。此项研究目的为观察上述两药联合外用治疗中、重     

表现为疼痛性斑块的麻风一例

麻风的临床表现错综复杂,麻风反应的临床表现也多种多样。我科诊断了一例模仿银屑病的界线类偏结核样型麻风伴I型麻风反应,本例患者长期误诊误治,临床表现为全身泛发的疼痛性斑块。现报道如下。临床资料患者,女,53岁。因双上肢斑块、鳞屑4年,泛发全身伴疼痛半年入院。4年前患者无诱因双上肢出现鸽蛋大红色斑块,上覆白色鳞屑,无自觉症状,未诊治。后皮损逐渐增多,伴疼痛,患者于当地医院就诊,诊断不详。     

Therapierefraktäre „Psoriasis vulgaris“

A 61-year-old patient had a 25-year history of erythematous scaling lesions, diagnosed and treated as psoriasis vulgaris. He presented with a growing nodule within the erythematous plaque. Biopsy shows epithelioid cell granulomas with prominent Langhans giant cells. There was no sign of a squamous cell carcinoma. The tuberculin test was strongly positive and M. tuberculosis complex was detected in the biopsy material by PCR. He was diagnosed with lupus vulgaris, the most frequent form of cutaneous tuberculosis. Other types include tuberculosis verrucosa cutis, tuberculosis cutis orificialis and disseminated military tuberculosis. The patient was treated with rifampicin, isoniazid, pyrazinamide and ethambutol for two months, following a four month treatment with rifampicin and isoniazid. The skin lesions rapidly resolved under antituberculotic treatment.     

Pagetoid reticulosis (Woringer‐Kolopp disease)

Pagetoid reticulosis (Woringer‐Kolopp disease) is a rare subtype of cutaneous CD8‐positive T‐cell lymphoma. A 41‐year‐old man presented with a 7‐year history with a slowly progressive erythematous plaque on his right buttocks. With the working diagnosis of psoriasis, he was treated with topical corticosteroids which produced no improvement. Histological examination showed an epidermotropic T‐cell lymphoma with predominance of CD8‐ vs.CD4‐positive lymphocytes. Based on the clinical picture and the histological findings, we diagnosed pagetoid reticulosis. Excision of the plaque and cream PUVA photo‐chemotherapy produced long‐term remission.     

Evaluation of the Vascular Pattern in Psoriatic Plaques in Children Using Videodermatoscopy: An Open Comparative Study

Psoriasis is a common erythematous desquamative dermatosis. The diagnosis may sometimes be troublesome in children, especially if clinical presentation is mild or atypical. Videodermatoscopy has been suggested as a new noninvasive aid for the diagnosis of psoriasis, prognostic evaluation, and treatment monitoring. An open comparative study in children aimed at assessing the correlation between the vascular pattern evaluated using videodermatoscopy and the clinical diagnosis of psoriasis and other erythematous desquamative disorders was designed and performed. Sixty Caucasian children were enrolled and subdivided into two groups: group A, 24 patients with multiple plaque psoriasis; group B, 36 patients with other erythematous desquamative disorders. At least two lesions were examined in each patient using videodermatoscopy at 150× magnification and the superficial vascular pattern of each lesion was evaluated in three different fields. In group A, the presence of dilated capillaries with a “bushy” aspect, homogeneously distributed in all examined fields, was seen in all considered plaques. In group B, videodermatoscopic findings were not specific, showing normal‐looking capillaries, slightly dilated vessels, or a few isolated “bushes.” Videodermatoscopy may be considered an important adjunct diagnostic tool in clinically doubtful erythematous desquamative lesions in children, allowing a psoriatic vascular pattern to be confirmed or excluded, with some distinct advantages over skin biopsy.     

Excellent response to ustekinumab in a 9‐year‐old girl with severe psoriasis

We report the case of a 9‐year‐old girl with severe plaque psoriasis refractory to multiple topical and systemic therapies. Physical examination revealed extensive, erythematous plaques with overlying thick scales that covered more than 80% of her body surface area, which included the face, scalp, trunk, and limbs. Because of the severity of the disease and lack of treatment response to other systemic therapies, she was treated with ustekinumab. Three weeks after ustekinumab was initiated, her psoriatic lesions fully cleared.     

Detection of early basal cell carcinoma with dermoscopy in a patient with psoriasis

A 49-year-old man with a history of basal cell carcinoma and psoriasis presented for routine skin exam and psoriasis management. He had multiple erythematous, scaly patches and plaques, originally diagnosed as psoriasis. Noticeably, one erythematous patch had a focal erosion. Dermoscopy revealed arborizing vessels, an erosion, pink structureless areas, and short, fine telangiectasias (SFTs), suggestive of superficial basal cell carcinoma (sBCC). Dermoscopy of all other lesions was consistent with psoriasis, exhibiting dotted vessels on a faint erythematous background. In conclusion, sBCCs may be overlooked in patients with multiple psoriatic plaques. In this case, the lesions were all initially presumed to be psoriasis. After detecting an erosion, the clinician was prompted to inspect further with dermoscopy and biopsy. Suspicion of sBCC was confirmed after visualization of dermoscopic structures consistent with sBCC. We highlight this case to encourage the use of dermoscopy in these patients for prompt diagnosis of BCCs.     

Bowen's disease concealed by purpura

Bowen's disease (BD) is a squamous cell carcinoma in situ characterized by a well-demarcated scaly erythematous thin plaque with an irregular outline. Clinically, BD is frequently misdiagnosed as superficial basal cell carcinoma, patches of dermatitis, psoriasis, lichen planus, actinic keratosis, benign lichenoid keratosis, irritated seborrheic keratosis, viral warts, amelanotic melanoma or melanoma. However, angiosarcoma has not usually been mentioned in the differential diagnosis of BD before. Herein, we describe two cases of BD presenting as purpura on the scalp of the elderly with an initial clinical suspicion of angiosarcoma.     

Sarcoidosis during infliximab therapy for Crohn’s disease

Tumor necrosis factor‐α (TNF‐α) antagonists are effective for inflammatory diseases, such as Crohn’s disease, rheumatoid arthritis (RA) and psoriasis. Although TNF‐α antagonists are also useful for sarcoidosis, paradoxical occurrence of sarcoidosis or sarcoidal reaction may be observed. We report a Crohn’s disease patient, who developed sarcoidosis during infliximab therapy. A 35‐year‐old man had been receiving infliximab for 7 months for Crohn’s disease. He developed cough and fever, accompanied by an infiltrated erythematous plaque on his right knee. The chest radiography, skin biopsy and laboratory findings were all consistent with sarcoidosis.     

Isolated linear blaschkoid psoriasis

Linear psoriasis (LPs) is considered a rare clinical presentation of psoriasis, which is characterized by linear erythematous and scaly lesions along the lines of Blaschko. We report the case of a 20‐year‐old man who presented with asymptomatic linear and S‐shaped erythematous, scaly plaques on right side of his trunk. The plaques were arranged along the lines of Blaschko with a sharp demarcation at the midline. Histological examination of a skin biopsy confirmed the diagnosis of psoriasis. Topical calcipotriol and betamethasone dipropionate ointments were prescribed for 2 months. A good clinical improvement was achieved, with reduction in lesion thickness and scaling. In patients with linear erythematous and scaly plaques along the lines of Blaschko, the diagnosis of LPs should be kept in mind, especially in patients with asymptomatic lesions of late onset.     

Efalizumab-associated papular psoriasis

BACKGROUND: Efalizumab is a human anti-CD11a monoclonal antibody used in the treatment of patients with moderate to severe plaque psoriasis. Some of the patients develop new papular lesions during treatment, which are predominantly located in the flexural regions. OBSERVATION: Four patients with recalcitrant psoriasis undergoing treatment with efalizumab presented with erythematous, partly scaly papules and small plaques on previously unaffected areas after 4 to 10 weeks of efalizumab therapy. Tissue sections of biopsy specimens were stained with hematoxylin-eosin, and immunohistochemical staining was performed using monoclonal antibodies against CD3, CD4, CD8, T-cell-restricted intracellular antigen 1, granzyme B, neutrophil elastase, CD68, CD1a, CD11c, HLA-DR, CD25, CD20, and CD56. Histopathological and immunohistochemical examination of the lesions showed features consistent with psoriasis and activation of various leukocyte subtypes including T cells, dendritic cells, macrophages, and neutrophils. CONCLUSIONS: Papular eruptions appearing during efalizumab therapy represent new psoriatic lesions and could be referred to as efalizumab-associated papular psoriasis (EAPP). They usually do not necessitate termination of efalizumab therapy and may optionally be treated with topical corticosteroids. Dermatologists should be aware of these lesions and inform their patients accordingly.