泛发性神经性皮炎继发鳞状细胞癌1例

患者男,75岁。2年前无明显诱因自觉四肢皮肤瘙痒,半年后双小腿及双肘皮肤粗糙,出现肥厚性斑块,瘙痒剧烈。3个月前左膝斑块处出现一增生性肿物。皮肤科情况四肢伸侧泛发大小不等的肥厚性斑块。左膝约3cm大小肿物。左膝肿物组织病理符合鳞状细胞癌。     

胫前黏液性水肿一例

患者男．48岁。因双侧胫前至足背部皮肤结节、斑块样肿胀。不痛不痒3年而于2002年3月6日来我院就诊。患者1999年2月骑摩托车时不慎碰伤左膝部．当心局部肿胀、疼痛伴皮肤轻擦伤。半月后伤处肿痛消退．双侧小腿开始出现水肿、青紫,左膝皮肤擦伤处出现一黄豆大小肿物．不痛不痒。1个月后双小腿肿胀开始缓慢向下移动,症状逐渐加重,     

伊曲康唑联合温热疗法治疗皮肤着色芽生菌病1例

1临床资料患者男,42岁,建筑工人.左膝疣状斑块3年.3年前患者在一次施工中不慎左膝受伤,经外用"消毒水"后伤口愈合.不久受伤处出现一黄豆大小暗红色结节,有痒感,常自行搔抓,皮损不断向外扩展,外院以"皮肤结核"予异烟肼、利福平、链霉素、吡嚷酰胺等治疗未见好转.     

左膝异位乳房外paget病1例

1临床资料患者,女,78岁。因"左膝反复红斑、糜烂、结痂伴瘙痒2年"入院。2年前患者左膝关节出现一块蚕豆大小的红斑,伴瘙痒,搔抓后出现糜烂,有少量渗液,按"湿疹"治疗,效果不佳。皮损逐渐扩大,形成斑块,触之有浸润感,时有结痂,在院外某医院诊断为"慢性溃疡",予抗感染治疗无效,遂来我     

硬皮病伴发血管性溃疡

本文报告7例硬皮病患者伴发网状青斑样血管炎,结节性动脉周围炎,闭塞性动脉内膜炎而产生溃疡。例1:54岁、男,发生在手和手指肢端型硬皮病,3年后下肢皮肤变厚,伴足部网状青斑。4年后,肘部皮肤钙化,面及胸背毛细血管扩张。72岁时因左足拇趾底部坏死性溃疡不愈而作左膝以下截肢手术。手术后发生横结肠多处穿孔,继发于增殖性     

多发性化脓性肉芽肿1例

患者女,19岁。左膝丘疹、结节10余年。皮肤科情况:左膝内侧长约15cm条索状瘢痕,两侧见较多淡红、灰红色丘疹、结节。组织病理符合化脓性肉芽肿。诊断:多发性化脓性肉芽肿。     

疣状皮肤结核

患者女,54岁. 主诉:左膝部附近发疹30年余. 现病史:30年前左膝部附近出现暗红色的小丘疹,无自觉症状,以后皮损逐渐扩大,形成黄豆至蚕豆大结节和斑块,有时搔抓后有少量出血、渗出、干燥结痂.30年来从未诊治过,近几月皮疹蔓延扩大.     

获得性骨关节梅毒3例

1临床资料 例1.男,50岁.因左膝肿胀、疼痛8个月,于2005年11月11日收入我院.2005年3月患者无明显诱因左膝出现肿胀、疼痛,左膝内侧轻度隆起,局部肤色正常.在院外诊断为"骨肉瘤".体格检查:一般情况良好,全身浅表淋巴结不增大.心、肺、腹未见异常.     

隆突性皮肤纤维肉瘤

患者男,50岁. 主诉:左膝内侧肿块16年. 现病史:患者16年前,无明显诱因发现左膝一红色皮疹,黄豆大,不突出皮面,不伴瘙痒、疼痛,未予特殊诊治.此后皮疹逐渐增大、变硬,并高出皮面,颜色逐渐加深,易破溃、出血并结痂.患者于2010年1月就诊于我科门诊,自觉皮疹较前增大,追问病史,患者诉局部曾有脓液流出,呈颗粒状.     

皮肤平滑肌瘤1例

<正>1临床资料患者女,36岁。因左膝部皮肤肿物伴阵发性疼痛2个月,于2010年11月就诊。患者于2月前发现左膝部皮肤有一枚绿豆大小结节样肿物,伴阵发性疼痛,病来皮损无红肿热,无糜烂、渗出、破溃,未觉明显收缩或蠕动感等。曾于当地诊所给予抗生素等(具体用药不详)治疗,无好转,且皮损     

Intralymphatic histiocytosis with granuloma formation associated with orthopaedic metal implants

A 75-year-old man presented with a 1-year history of asymptomatic reddish-brown nodules on his left knee, in which orthopaedic metal implants had been inserted for a transformation-related knee joint disorder. Histopathological examination revealed typical features of mixed cell granuloma with many dilated lymphatics that contained many histiocytes from the upper dermis to subcutaneous fat tissue. Results of qualitative analysis of biopsy specimens by energy-dispersive X-ray spectroscopy were positive for molybdenum, which was one of the constituents of the metal implant. We describe the first observation of intralymphatic histiocytosis with granuloma formation in the skin occurring in a patient bearing orthopaedic metal implants for a transformation-related knee joint disorder.     

The lesional skin of linear IgA bullous dermatosis expresses growth-regulated peptide (GRO)-alpha

The patient was a 62-year-old man with erythema with tense vesiculobullae and erosions on the bilateral elbows, right knee, and one buttock. A skin biopsy specimen revealed subepidermal blister formation with a predominant infiltration of neutrophils and papillary neutrophilic microabscesses. Direct immunofluorescence study showed linear deposition of IgA and weak deposition of IgG at the basement membrane zone of the lesional skin, and indirect immunofluorescence study showed linear deposition of IgA at the epidermal side of the 1M NaCl-separated normal skin. He was diagnosed with linear IgA bullous dermatosis. Immunohistochemical study revealed that the lesional and perilesional keratinocytes expressed growth-regulated peptide (GRO) -alpha, a potent chemoattractant for neutrophils. This suggests that GRO-alpha plays a role in the infiltration of neutrophils into the lesional skin and in bulla formation in linear IgA bullous dermatosis.     

龟分枝杆菌和偶发分枝杆菌皮肤感染

报告1例皮肤龟分枝杆菌和偶发分枝杆菌感染。患者男,42岁。左膝关节结节、斑块2年,逐渐增大。1个月前局部皮肤出现肿胀、破溃。皮肤科检查可见左膝关节有一7cm×5cm暗红色斑块,中心有脓性分泌物。分枝杆菌培养阳性,经鉴定为龟分枝杆菌和偶发分枝杆菌。经抗分枝杆菌治疗,皮损明显改善。     

偏侧性汗孔角化症1例

报告1例偏侧性汗孔角化症。患者男，49岁，自出生后于左膝关节伸侧出现多个环状褐色斑，逐渐扩大，渐波及左侧躯体，部分皮损为线条状角化性斑块，伴瘙痒。无家族史。皮肤组织病理检查结果符合汗孔角化症。     

Disseminated lobular capillary hemangioma (pyogenic granuloma). A clinicopathologic study of two cases

The eruption of multiple lobular capillary hemangiomas (granulomata pyogenicum) is a previously documented but uncommon phenomenon. Reported cases have featured the recurrence of multiple satellite lesions after surgical removal of, or trauma to, a solitary capillary hemangioma. Sporadic cases of multifocal lesions arising de novo in both previously traumatized and uninjured skin have been described as well. We describe herein two unusual patients with disseminated lobular capillary hemangioma. One patient developed skin nodules in several sites, including the mouth, knee, thumb, and foot, after surgical removal of a solitary oculocutaneous neoplasm. The second patient had more than 700 skin lesions, distributed over the entire body. Unlike those in most previously reported examples of this condition, these two patients were elderly. Both were misdiagnosed clinically as having malignant vascular neoplasms, but the behavior of the lesions was benign, despite conservative surgical excisions in one patient and relative lack of therapeutic intervention in the other.     

Use of micro-focused ultrasound with visualization to lift and tighten lax knee skin

Abstract

Introduction: Public interest in noninvasive, aesthetic treatments for the rejuvenation of appearance continues to grow. The following prospective, open-label, nonrandomized trial was conducted to evaluate the safety and efficacy of micro-focused ultrasound with visualization (MFU-V) for achieving lift and tightening of lax skin above the knee. Materials and methods: Healthy adult women (N = 30) with mild- to moderate bilateral skin laxity above the knees were enrolled. MFU-V was applied to a grid of eight 25 mm² squares above each knee. MFU-V was first applied using a 4 MHz, 4.5 mm transducer followed by a 7 MHz, 3.0 mm transducer. Approximately 480 treatment lines applied to each knee. The primary efficacy endpoint was lifting and tightening of lax skin above the knee as determined by the principle investigator using the Physician Global Aesthetic Improvement Scale (PGAIS). Results: Among 28 evaluable subjects, 24 subjects (86%) showed improved lifting and tightening of knee skin laxity at 90- and 180-day follow-up visits. Three subjects showed no change and the appearance of one subject worsened. There were no adverse events or evidence of skin injury. Conclusion: Similar to its safety and efficacy for tightening facial skin and reducing wrinkles, MFU-V is an effective, noninvasive method for reducing skin laxity and improving the appearance of skin above the knee. ClinicalTrials.gov Identifier: NCT01708434.     

Pyoderma gangrenosum-like ulcer caused by Helicobacter cinaedi in a patient with x-linked agammaglobulinaemia

Cutaneous lesions of the legs have been linked to Helicobacter species in a number of patients with X-linked agammaglobulinaemia (XLA), a primary immunodeficiency. We describe a 26-year-old patient with XLA, who was referred with an extensive skin ulcer that enlarged gradually over the course of 7 years. The ulcer resembled pyoderma gangrenosum (PG), and extended from below the knee to the ankle. The man (who has sex with men) was negative for human immunodeficiency virus. Helicobacter cinaedi was identified by 16S ribosomal (r)DNA PCR analysis from a biopsy of the lesion. This fastidious organism has been implicated previously in causing unexplained skin macules in one other patient with XLA. We suggest that early consideration of infection with Helicobacter species in immunocompromised patients who present with unexplained cutaneous lesions is important, as a prolonged antibiotic course can lead to clinical improvement.     

Metallic Discoloration on the Right Shin Caused by Titanium Alloy Prostheses in a Patient with Right Total Knee Replacement

The differential diagnosis of bluish-gray pigmentation of the skin includes dermal melanocytosis, malignant melanoma and metallic discoloration. Of these disorders, metallic discoloration, which develops from deposits of fine metallic particles on the skin, is an uncommon dermatologic disease. We report a case of metallic discoloration of the right shin caused by titanium alloy prostheses in a patient with right total knee replacement. The patient had bluish-gray pigmentation on her right shin as well as pain while walking. Histopathologic findings of the skin lesion showed abundant black particles in the perivascular area of the lower dermis. Polarizing microscopy revealed refractile foreign materials in the dermis. An energy dispersive X-ray spectrophotometer unit attached to a transmission electron microscope detected titanium and aluminium peaks in the specimen.     

Increased procollagen alpha1(I) mRNA expression by dermal fibroblasts in melorheostosis

We report a patient with melorheostosis in whom increased procollagen alpha1(I) mRNA expression and alpha1(I), alpha2(I) and alpha1(III) collagen secretion were observed in dermal fibroblasts obtained from a skin biopsy overlying the involved bone. The patient was a 53-year-old man with melorheostosis lesions over the left knee joint. Multiple pigmented macules were present on the medial aspect of the lower left leg. Hyperpigmentation of the basal keratinocytes, thick-walled vessels in the reticular dermis, and proliferation of normal-appearing collagen around the hair follicles were observed histologically.     

A 13-year-old girl with recessive dystrophic epidermolysis bullosa presenting with squamous cell carcinoma

Recessive dystrophic epidermolysis bullosa (RDEB) is an uncommon and severely disabling genetic disorder characterized by trauma-induced blisters, intractable skin ulcers, scarring, milia, and nail dystrophy. Patients with RDEB have an increased tendency for fast-growing and early metastasizing squamous cell carcinoma (SCC). We report here a 13-year-old girl with RDEB who developed a large SCC on the left knee. At 6 months of evolution it was resected and covered with an autologous skin graft. To our knowledge, this is the youngest patient with RDEB complicated by SCC to be reported, and therefore may serve to emphasize the importance of vigilance in surveying RDEB patients for SCC.