网状红斑黏蛋白病并发蕈样肉芽肿1例

报告网状红斑黏蛋白病并发蕈样肉芽肿1例。患者女。42岁。因躯干、上肢红斑14年,皮损增多,加重5年就诊。6年前行皮损组织病理学检查示真皮乳头层及网状层有大量黏蛋白样物质沉积,诊断为网状红斑黏蛋白病,入院皮肤科检查：头部、面部、颈部、躯干、四肢见片状轻度浸润性红斑,部分融合成网状,腹部红斑上可见紫红色浸润性斑块。皮损组织病理检查：真皮肉淋巴细胞苔藓浸润,部分细胞异形,少量浸润细胞移入表皮,形成Pautrier样微脓种,免疫组化染色结果示：LCA（＋＋＋）,CD45RO（＋＋＋）,诊断。蕈样内芽肿。     

进行性对称性红斑角皮症1例

患儿女，４岁，因面部、四肢、手足弥漫性红斑、角化过度３年余，于２００１年３月２３日就诊。患儿出生后３个月，无明显诱因面部出现２个指甲盖大小红斑，逐渐增大、增多，累及整个面颊。至１岁时呈边界清楚片状红斑，同时双掌跖出现弥漫性红斑，表面鳞屑，伴角化过度，无自觉症状。皮损逐渐扩大波及手足背及四肢，皮损处出汗不良。每于遇热、运动、感冒、发热时病情加重，皮损缓慢进展，冬重夏轻。父母非近亲结婚，家族中无相同病史。查体：发育良好，心、肺、腹未见异常。皮肤科情况：皮损累及面部、四肢及掌跖，为边界清楚之红斑、鳞屑…     

镰刀菌皮肤肉芽肿1例

报告1例镰刀菌皮肤肉芽肿。患者男,21岁。面部出现红斑、丘疹、溃烂、结痂20年,四肢皮肤疣状增生3年,面部遗留毁容性瘢痕及组织缺损。多次取不同皮损处皮屑作真菌培养,均见相同菌落生长,经菌种鉴定为镰刀菌属。皮损组织病理学检查示表皮乳头瘤样增生,表皮浅层见多量菌丝,菌丝有分隔。流式细胞仪检测发现患者细胞免疫功能低下。根据药敏试验结果采用特比萘芬治疗,其疗效正在进一步随访观察中。     

网状红斑黏蛋白病1例

报告1例网状红斑黏蛋白病。患者男，49岁。头面部、胸背部红斑、丘疹伴瘙痒10年，日晒后皮损无明显改变。组织病理检查示真皮乳头层，网状层上部血管及毛囊周围淋巴细浸润，真皮胶原束之间有阿新蓝染色阳性的黏蛋白沉积。     

骨膜增生厚皮症合并慢性光化性皮炎1例

患者男,56岁,头面部手足皮肤增厚5年,加重伴面部红斑、丘疹、结节伴痒1年。皮肤科情况：面部、双耳皮肤可见浸润性红斑,其上可见散在结节、丘疹,皮肤油脂较多;前额皮肤可见皱褶及沟纹,头皮增厚呈回状,双手及双足可见杵状指/趾,双踝关节肿胀。X片提示长骨骨膜不规则增生,面部皮损组织病理符合慢性光化性皮炎。诊断：骨膜增生厚皮症合并慢性光化性皮炎。予以抗炎、抗组胺等治疗后部分皮损缓解。     

红斑型天疱疮误诊1例

 报告红斑型天疱疮误诊1例。患者女,42岁,全身红斑、鳞屑1年。皮肤科检查：面部对称性水肿性红斑,上覆黄白色细痂屑;躯干、四肢见环形浸润性暗红斑,边缘稍隆起,中央消退见褐色色沉,边界清楚,腹部红斑基础上见3个黄豆大小的水疱,疱液清亮,疱壁松弛,尼氏征可疑阳性。天疱疮抗体Dsg1、Dsg3均阳性。面部皮损组织病理结果示：角化不全,角质层及棘层上部裂隙,可见棘突松解现象。直接免疫荧光：棘层上方IgG网状沉积。诊断：红斑型天疱疮。予泼尼松片、羟氯喹联合甲氨蝶呤片治疗后,面部红斑减轻,躯干皮损消退后出院,随访1年皮疹无复发。     

皮肤念珠菌性肉芽肿合并念珠菌性颈淋巴结炎1例

报告皮肤念珠菌性肉芽肿合并念珠菌性颈淋巴结炎1例。患者女，27岁。面部增生性红斑5年，颈部淋巴结肿大2个月。取面部皮损咽部黏膜及颈部淋巴结进行培养，鉴定为白念珠菌生长，组织病理检查示皮肤念珠菌肉芽肿，念珠菌性淋巴结炎。流式细胞仪检查发现患者细胞免疫功能低下，采用氟康唑静脉滴注，同时使用胸腺肽，并口服特比萘芬，治疗2个月，患者面部皮损明显改善，颈部淋巴结缩小。     

肿胀性红斑狼疮误诊为过敏性皮炎

报告1例肿胀性红斑狼疮。患者女,24岁。面部反复出现红斑、斑块1年半,加重10 d。皮肤科检查:双侧面颊红斑、斑块,无鳞屑、瘢痕及萎缩。皮损组织病理检查:表皮角化过度,基底层及毛囊上皮细胞液化变性,血管及毛囊周围淋巴细胞及组织细胞浸润。阿辛蓝染色示真皮网状层黏蛋白沉积。根据其临床、皮损组织病理及免疫病理表现,诊断为肿胀性红斑狼疮。     

可变性红斑角化病1例

患者男,2岁。面部及腋下红斑1.5年。皮肤科情况:面部、颈部、双腋下及躯干部淡褐色角化过度性斑片,双手足角化过度,轻度脱屑。皮损组织病理示:表皮角化过度,棘层轻度肥厚,真皮浅层毛细血管周围少量以淋巴细胞为主的细胞浸润。诊断:可变性红斑角化症。     

Morbihan病国内首报

报告国内首例Morbihan病。患者男,40岁。面部红斑及肿胀3年。皮肤科检查:上面部弥漫性淡红斑和以眼眶为中心的非凹陷性水肿,皮损边界不清。皮损组织病理检查:表皮大致正常,真皮浅层毛细血管扩张,血管和附属器周围组织细胞和以淋巴细胞为主的炎性细胞浸润,可见少量中性粒细胞。阿辛蓝染色阴性。诊断:Morbihan病。     

Histopathological Features of Recalcitrant Erythema of the Face in Adult Patients with Atopic Dermatitis

Recalcitrant erythema on the face of 21 adult patients with atopic dermatitis was histologically examined. All patients had been applying topical corticosteroids to the facial erythema for three years or more. The histopathology of the recalcitrant facial erythema was not homogeneous. Thus, the facial erythema was roughly classified into three categories: 1) erythema which mainly showed eczematous changes, 2) erythema which mainly showed steroid-induced rosacea-like changes, and 3) erythema which showed both eczematous changes and steroid-induced rosacea-like changes. The majority (75%) of recalcitrant facial erythema belonged to the third category.     

皮肤镜辅助诊断不典型泛发性体癣一例

患者,女,24岁.面、躯干、双上肢红斑、鳞屑伴痒3个月.皮肤科查体:面部、躯干、双上肢散在分布绿豆至黄豆大红斑,上有少许白色鳞屑,部分皮损中心破损结痂.皮肤镜检查提示可能存在真菌感染,建议行真菌检查.真菌涂片镜检:菌丝阳性;真菌培养为犬小孢子菌.诊断为体癣.经抗真菌治疗后痊愈,随访无复发.     

儿童线状IgA大疱性皮病1例

患儿男,2岁9个月。面颊、背部、双下肢泛发红斑、水疱伴疼痛15天。皮肤科情况:双侧面颊、耳廓可见红斑、糜烂,部分结痂。双下肢遍布黄豆大水疱,疱壁紧张,疱液清亮,尼氏征(-)。皮损组织病理示表皮下水疱形成,疱内可见浆液、中性粒细胞、淋巴细胞及嗜酸性粒细胞。免疫荧光IgA(+),基底膜可见线状沉积。诊断:儿童线状IgA大疱性皮病。     

Use of light-emitting diode photomodulation to reduce erythema and discomfort after intense pulsed light treatment of photodamage

Objectives This study evaluates the use of light‐emitting diode (LED) photomodulation therapy to accelerate resolution of post–intense pulsed light (IPL) erythema. Methods In this split‐face study, 15 subjects were randomized to receive LED treatment to one side of the face as determined by computer‐generated randomization numbers. All 15 subjects received a single IPL treatment for facial photodamage. Immediately after IPL treatment, one side of the face was treated for 35 s with the LED device. The other side was not treated. Subjects returned 24 h later for a second LED treatment on the same side of the face. Posttreatment erythema was rated on both sides of the face by the blinded investigator and by subjects immediately after IPL treatment, 24 h later, and 1 week later on a scale of 0% (no erythema) to 100% (severe erythema). Patients commented on posttreatment discomfort immediately after IPL treatment. Results Mean erythema scores on the first visit were significantly higher (P = 0.0054) on the side not treated with LED (52.7 ± 24.6) than on the LED‐treated side (43.3 ± 21.9). Visit 2 data showed a similar trend (P = 0.0281). The subjects reported similar findings with mean erythema scores on the first visit on the LED‐treated side (46.7 ± 25.3) compared with the untreated side (60.0 ± 23.3); the difference was significant (P = 0.0382). On the second visit, the mean erythema scores trended lower on the LED‐treated side (24.3 ± 22.1) than on the untreated side (27.9 ± 25.8), but the difference did not reach statistical significance (P = 0.1365). Erythema scores on both facial sides were 0 for all subjects 1 week after IPL treatment. Four patients commented that posttreatment discomfort was considerably less on the LED‐treated side immediately after treatment. Conclusion LED photomodulation treatment may accelerate the resolution of erythema and reduce posttreatment discomfort in IPL‐treated patients with photodamage.     

呈网状红斑改变的扁平苔藓

报告1例呈网状红斑改变的扁平苔藓。患者女,34岁。全身泛发网状红斑22年,伴瘙痒,有口腔黏膜及甲受累。皮肤科检查见全身泛发网状红斑,部分红斑消退后局部有轻度萎缩,散在水疱,尼氏征阴性。双手多个指甲甲板萎缩、吸收。上腭见片状糜烂面。组织病理检查示表皮变薄,基底细胞广泛液化变性,真皮浅层淋巴细胞呈带状浸润。诊断：扁平苔藓。给予阿维A40mg/d口服3个月后皮损明显变平,颜色变暗。     

成人斯蒂尔病1例

患者女,69岁。右侧面部红斑、水疱后疼痛14个月,反复发热、关节痛1年,全身散在分布皮疹5月。体检:面部片状暗红斑,上覆暗红色和黄色痂皮,痂皮下可见点状溃疡和脓性分泌物;背部及双侧上肢散在分布10余个约1.0cm×1.5cm大萎缩性斑块,表面有少许痂屑,部分挤压后有少许脓液;右侧肘部可见淡红色斑块,内侧有一直径约0.5cm的厚壁水疱,疱液稠。实验室检查:血白细胞、中性粒细胞均升高,血清铁蛋白增高,类风湿因子、抗核抗体阴性,抗生素治疗无效。皮损组织病理示:真皮浅层及血管壁部分淋巴细胞、中性粒细胞浸润,淋巴结活检呈反应性增生改变。诊断:成人斯蒂尔病。     

成人线状IgA大疱性皮病1例

患者女,43岁。面颈部及躯干反复出现红斑和水疱7月。皮肤科情况:面颈部及躯干泛发水肿性红斑、丘疹和张力性小水疱,呈环状排列。皮损组织病理示:表皮下水疱,疱内及真皮可见大量嗜酸性粒细胞浸润,真皮层有少许中性粒细胞等炎性细胞浸润。直接免疫荧光见基底膜带IgA呈线状沉积。诊断:成人线状IgA大疱性皮病。予氨苯砜治疗2周,起效快,疗效好。     

多中心网状组织细胞增生症1例

患者女,55岁,面颈部皮疹1年,指关节变形6个月.皮肤科情况:面颈部、耳廓弥漫性红斑,以曝光部位为主;鼻周散在黄红色丘疹,无破溃.齿龈见红色丘疹,前胸V字区见水肿性红斑,无水疱.双手X线片示近节及远节指间关节均有不同程度破坏,致使关节畸形,软组织肿胀.鼻翼皮损组织病理示:真皮内大量组织细胞及嗜酸性胞浆的多核巨细胞浸润....     

盘状红斑狼疮继发上唇疣状癌合并双手寻常疣1例

患者男,50岁。面部红斑10年,上唇及双手背疣状肿块3年,上唇肿块生长加快4月。皮肤组织病理检查:面部红斑皮损示:表皮角化过度伴灶性角化不全,可见角质栓,棘层肥厚,基底细胞液化变性,真皮内炎症细胞密集浸润。上唇疣状肿块示:角化不全,棘层不规则增生肥厚,有大量空泡化细胞,可见鳞状窝形成及少量角化不良细胞,未突破基底膜,真皮内血管增生,周围淋巴细胞块状浸润。右手拇指根部肿块活检符合寻常疣。诊断为盘状红斑狼疮继发上唇疣状癌合并双手寻常疣。     

Eritema anular centrífugo e hipotiroidismo

—A 54-year-old woman consulted her physician because of some erythematous lesions with scaling borders on the outer face of both legs, suggesting erythema annulare centrifugum. Complementary examinations showed subclinical hypothyroidism which improved, as did the skin lesions, with levothyroxine. Later imbalance in the treatment caused the hypothyroidism to reappear, this time clinical, and also allowed two new outbreaks of erythema annulare centrifugum