幼儿扁平黄瘤并多发性咖啡斑1例

患儿男,1岁7个月,头皮、躯干丘疹、色素沉着斑1年余.出生时躯干散在大小不等浅褐色圆形、椭圆形色素沉着斑,在6个月时出现头皮及躯干皮疹,为大小不等黄色斑丘疹、斑块,未诊治.皮损组织病理示:真皮局部区域见泡沫细胞增生;免疫组织化学示:CD68(+),符合皮肤扁平黄瘤病理改变.诊断:扁平黄瘤并多发性咖啡斑.     

脂质化纤维组织细胞瘤

报告1例脂质化纤维组织细胞瘤。患者男,43岁。因右小腿肿块渐进性增大10年余就诊。皮肤科检查:右小腿伸侧近踝关节处有一2.5 cm×2.5 cm半圆球形暗褐色肿块,质硬,活动度差。皮损组织病理检查:肿瘤组织位于真皮层,主要由泡沫样细胞及多量玻璃样变性的胶原纤维构成,胶原纤维似骨基质样、金属丝样,肿瘤边缘处可见少量呈席纹状排列的梭形细胞。免疫组化检查示CD10(+),CD68(+),CD34(-)、波形蛋白(+),诊断为脂质化纤维组织细胞瘤。     

多发性结外鼻型NK/T细胞淋巴瘤1例

患者男,60岁,藏族。全身斑块、结节及肿块6月,肿块破溃伴疼痛2月。皮损病理组织示:表皮变薄,基底层液化变性,瘤细胞在真皮及皮下脂肪层呈弥漫性浸润,瘤细胞形态不一,核深染,可见血管中心性浸润及凝固性坏死。免疫组化标记瘤细胞CD3,CD3ε,CD56,TIA-1,粒酶B均为(+),CD30约10%(+),CD8(-),CD79a(-),EBER1/2原位杂交(+)。TCR-γ重排未见明确克隆性重排条带。诊断:皮肤结外鼻型NK/T细胞淋巴瘤。     

肩背部单发性血管球瘤1例

患者男,44岁。左肩背部结节伴触痛20余年。皮肤科情况:左肩背部一个蚕豆大小暗红色结节,结节表面光滑。皮损组织病理示:真皮中下部可见瘤细胞团块,瘤团由血管腔和血管球细胞组成。免疫组化:血管球细胞vimentin(+),SMA(+),S-100(-)。诊断:单发性血管球瘤。     

右前臂单发性血管球瘤1例

患者男,58岁。右前臂出现单个结节伴触痛5年。皮肤科情况:右前臂伸侧一个黄豆大淡蓝红色结节,结节表面光滑,可见毛细血管扩张。皮损组织病理:真皮中下部可见瘤细胞团块,瘤团由血管腔和血管球细胞组成。免疫组化:血管球细胞vimentin(+),SMA(+),S-100(-)。诊断:单发性血管球瘤。     

表现为脱发并多种皮疹的二期梅毒1例

患者男,51岁。脱发并头皮、口周、腰部、双上肢、会阴、掌跖散在分布红斑4个月。实验室检查:TPPA(+),RPR 1∶128(+),HIV抗体(-)。诊断:二期梅毒。予苄星青霉素240万U分两侧臀部肌注,1次/周,连用3次后皮损基本消退。     

迟发型多发性脂囊瘤

报告1例罕见部位的迟发型多发性脂囊瘤。患者女，64岁。头皮、面部和耳部多发黄色结节10年。皮肤科检查：头皮、面部和外耳道多发，表面光滑，均匀，淡黄色的囊性结节。皮损组织病理：真皮下一囊腔，囊内为淡红色均质物质，囊壁为复层鳞状上皮，缺乏颗粒层，囊壁可见多个皮脂腺附着。诊断：多发性脂囊瘤。     

头皮巨大鳞状细胞癌1例

报告1例头皮巨大鳞状细胞癌。患者女,56岁,头顶部菜花样肿物5月余,逐渐增大。皮肤科检查:头顶可见一巨大肿物,约10 cm×9 cm大小,表面粗糙呈菜花状,高出皮面。组织病理示:表皮假性上皮瘤样增生;真皮见鳞状细胞瘤团和角化珠,少许细胞异型,见角化不良细胞,瘤团及血管周围淋巴组织细胞浸润。诊断:头皮巨大鳞状细胞癌。     

头皮恶性血管内皮细胞瘤1例

报道1例老年人头皮恶性血管内皮细胞瘤。患者颈部、颞部及顶部头皮进行性暗红色斑片、斑块及溃烂、结痂5个月。皮损病理活检可见真皮内大量瘤细胞浸润,瘤细胞大部分由梭形细胞和不典型立方形细胞组成,核异型明显。免疫组化示瘤细胞CEA(-)、EMA(-)、p-CK(-)、CD31(+)、CD34(+)、Ⅷ因子部分(+)、Ki-67约5%(+)。根据临床表现及组织病理学改变,诊断为头皮恶性血管内皮细胞瘤。     

多脏器累及的亲表皮CD8~+ T细胞淋巴瘤1例

患者男,46岁,全身渗出性红斑、头皮脓肿9月。入院检查发现累及肺、肝脏,皮肤组织病理示:表皮海绵水肿,真皮弥漫淋巴细胞,异型细胞具亲表皮性,免疫组化示:LCA(+),CD8(+),TIA(+),TCR基因重排阳性,诊断:亲表皮CD8+皮肤T细胞淋巴瘤。予以2次CHOP化疗,无效死亡。本病在国内首次报道,具有独特临床病理特点,早期累及皮外,侵袭性高,无有效治疗方法,预后差。     

以斑状脱发为首发症状的弥漫性神经纤维瘤一例

患者男,42岁,因头部斑状脱发伴头皮肿胀2年余就诊。皮肤科检查：左侧头皮见一10cm×8cm的肿块,境界清楚,略高起皮面,表面毛发脱落,触之柔软。皮损组织病理检查：肿瘤位于真皮深部和皮下脂肪组织,主要由短梭形细胞构成,可见特征性Meissner小体样结构;肿瘤基质疏松,散在肥大细胞。免疫组化：50％肿瘤细胞表达S-100。诊断：弥漫性神经纤维瘤。确诊后,鉴于皮损累及头部面积较大,患者拒绝手术治疗,目前仍在随访中。     

31例成年男性头发生长特性的初步观察

目的 探讨中国成年男性头发的生长特性.方法 将31名志愿者头皮顶部及颞部各剃去约1.2 cm×1.2 cm范围内的头发;间隔7天后对上述部位微距照相,分析图像,得到头发密度及头发生长速度;拔取观察部位的头发,显微镜下测量头发尖端、中部及根部的直径.结果 31例成年男性头发密度为(132±42)根/cm²,顶部的头发密度显著高于颞部(P<0.001).头发生长速度为(461±44)μm/d,颞部的头发生长速度显著高于顶部(P<0.01).头发直径为(97±9)μm,顶部和颞部之间头发直径差异无统计学意义(P>0.05),头发尖端、中部及根部之间直径的差异亦无统计学意义(P>0.05).结论 与白人和非洲人相比,中国成年男性头发的密度较低,但头发生长速度较快.     

Circumscribed alopecia: an unusual manifestation of pediculosis capitis

A healthy 10-year-old girl was referred for evaluation of patchy hair loss on the scalp of longer than 6 months duration. She had been diagnosed and treated for head lice approximately 1 month before onset of the hair loss. Examination of the scalp showed discrete ovoid patches of hair loss at the vertex scalp. A scrape of the area of hair loss was performed, and a nit was visible on microscopic examination. Focal hair loss may represent an atypical manifestation of ongoing pediculosis capitis.     

Characterization of 5 alpha-reductase in cultured human dermal papilla cells from beard and occipital scalp hair

In order to gain a deeper insight into the role of 5 alpha-reductase in the growth of beards in men, we studied some kinetic properties of the enzyme in cell homogenates of cultured human dermal papilla cells from beard and occipital scalp hair. When cell homogenates were incubated with [3H]-testosterone, the 5 alpha-reductase of beard dermal papilla cells exhibited an optimum activity at pH 5.5, whereas the enzyme of dermal papilla cells from occipital scalp hair showed a broad and low plateau between pH 6.0 and 9.0, without a sharp peak. The apparent Michaelis constant of 5 alpha-reductase was 3.3 x 10(-7) M in dermal papilla cells from beard and 2.4 x 10(-5) M in those cells from occipital scalp hair. The apparent Km of 5 alpha-reductase for NADPH was 2.8 x 10(-5) M and 7.6 x 10(-4) M in beard and occipital scalp hair dermal papilla cells, respectively. There were no significant differences in the substrate specificity between these two types of cells. The 5 alpha-reductase activity was recovered mainly in the nuclear fraction of beard dermal papilla cells. By contrast, it was widely distributed among the individual subcellular fractions of dermal papilla cells from occipital scalp hair. These results strongly suggest that these two kinds of dermal papilla cells have different types of 5 alpha-reductase, and that the enzyme in beard dermal papilla cells is similar in characteristics to that in the androgen target organs such as prostate.     

Significant relationship between temporal hair loss and other scalp areas in female pattern hair loss

Female pattern hair loss affects the central scalp, sparing the frontal hairline. The temporal area can also be affected by hair loss. We investigated the degree of temporal hair loss and correlation of other sites of scalp hair loss in Korean female pattern hair loss patients. A total of 109 women with female pattern hair loss were enrolled in this retrospective analysis. We measured hair density and thickness in five scalp sites including the frontal, vertex, occipital and bilateral temporal areas by phototrichogram. Frontal and vertex area hair loss were classified according to the Basic and Specific (BASP) classification, and temporal scalp and occiput areas were also assessed. Eighty-nine patients showed temporal hair loss. The mean of the hair density was lowest in the temporal area among all scalp areas. Total and thick hair densities of the frontal scalp were correlated with those of the vertex, temporal scalp and occiput in descending order, and hair thickness of the frontal scalp was more related with that of the temporal scalp than the vertex. In this study, temporal involvement is evident in female pattern hair loss. We suggest that temporal involvement should be added to pattern hair loss classification, especially BASP classification.     

Acute alopecia totalis

From a group of 1,189 AA patients seen in our dermatology unit, thirteen (3 males, 10 females) experienced hair shedding that started profusely and diffusely over the entire scalp. They were under observation for about 5 years, histopathology and trichograms being performed in all instances. The mean age of the patients was 26.7 years. It took only 2.3 months on average from the onset of hair shedding to total denudation of the scalp. The trichogram at the time of diffuse shedding showed that about 80% had dystrophic roots and the remaining 20% had telogen roots. Histopathological findings and exclamation mark hairs were compatible with alopecia areata. Regrowth of hair was noted 3.2 month after the onset of hair shedding and recovery observed in 4.8 months. All patients were treated by methylprednisolone pulse therapy. During the follow-up period, 53 months on average after recovery, 8 of the 13 patients (61.5%) showed normal scalp hair without recurrence, in 4 patients the recovery was cosmetically acceptable in spite of focal recurrences and only 1 patient showed a severe relapse after recovery. Considering all of the above findings, this group of the patients should be delineated by the term acute alopecia totalis.     

A controlled study of the effects of RU58841, a non-steroidal antiandrogen, on human hair production by balding scalp grafts maintained on testosterone-conditioned nude mice

Summary Human hair growth can be monitored for several months after the transplantation of scalp samples from men with androgen-dependent alopecia on to female nude mice. Hair production from balding sites has been shown to be inhibited in testosterone-conditioned nude mice. We used this recently reported model to study the effect of a new non-steroidal antiandrogen – RU 58841 – on human hair growth. Twenty productive scalp grafts from balding men were maintained for 8 months after grafting on to nude mice, and hair production was monitored monthly for 6 months. All mice were conditioned by the topical application of testosterone (testosterone propionate. 300 μg in 10μL; 5 days/week) on the non-grafted flank. The scalp samples were divided equally according to the estimated hair production potential, which was based on the amount of hair present on the scalp samples before grafting. Each of the two equal groups of grafts was further allocated at random to be treated topically (5 days/week) with blinded solutions of either RU 58841 1% in ethanol, or ethanol as a control.
Twenty-eight active follicles appeared on the 10 control grafts. Among them only two follicles (7%) initiated a second hair cycle. However, the 10 RU58841-treated grafts bore a total of 29 active follicles, and eight of them (28%) showed a second cycle. The values for the linear hair growth rates (LHGR) were significantly (P<0.04) higher in the RU58841-treated group. Recycling and increased LHGR indicate a positive action for RU58841 on human hair growth from balding samples grafted on to testosterone-conditioned nude mice, and encourage a clinical trial to evaluate its potential in the treatment of androgen-dependent alopecia.     

Hereditary hypotrichosis simplex: report of a family

We report a family with hereditary hypotrichosis simplex of the scalp, a rare disorder that was first described in 1974. In our family, four out of 10 siblings were affected, including three females and one male. Examination showed thinning of the scalp hair and sparse body hair. Eyebrows, eyelashes, pubic and axillary hair were normal. Skin, nails and teeth were also normal. Hair shaft examination did not reveal any structural abnormalities. Normal follicular units, hair shafts within follicles, eccrine glands and a lack of inflammation were seen on histopathology. The primary pathology underlying this genodermatosis is unclear, but the anagen phase of the hair cycle is clearly compromised.     

PLICA NEUROPATHICA AFTER USING HERBAL SOAP

A 22-year-old woman was referred to dermatology from oncology for an opinion regarding the sudden matting of scalp hair of 10 days duration. A case of primary infertility for 7 years, this patient was undergoing chemotherapy with doxorubicin, cyclophosphamide, and cisplatin after operative removal of a papillary cystadenoma (clear ceil type) from her left ovary 40 days previously.
She had noticed a sudden matting of her hair 3 to 4 hours after using a soap containing Acacia concinna for washing her hair. All efforts to disentangle the matted hairs were futile. She was feeling very uncomfortable because of the heavy solid mass of tangled hair. She told of rubbing her wet hair and using a wet towel to cover her hair after use of the soap. She denied earlier use of the soap, shampoo, setting lotions, bleaches, or hair dye. She had not cut her hair since early childhood.
Examination showed a huge, firm almost stony mass of severely tangled hair on her scalp, which was more marked over the vertex and occipital areas (Figs. 1 and 2). The hairs in the frontal area were free, thin, and straight. The skin over the entire scalp was normal. On light microscopy, a few hairs showed features of trichorrhexis nodosa. Routine hematology was normal. The patient was unable to tolerate the pain and discomfort because of the stony hard mass. She shaved her head and offered her hair in a temple, as is a common custom in parts of South India.