炎性乳腺癌误诊1例分析

<正>1临床资料患者女,56岁。右侧乳房迅速增大、红斑、丘疹7个月,累及左胸伴瘙痒4个月。7个月前,患者右侧乳房迅速增大,无疼痛、灼热等不适,其后病变处皮肤逐渐出现红斑、丘疹,无瘙痒,皮疹缓慢增多。自行口服"乳腺增生药"数天后病情无缓解,在当地行B超检查提示囊肿,遂继续于当地诊所输液治疗(具体不详)。6个月前,患者于外院诊断为"炎性乳腺癌"行第一次化疗。其后当地医院考虑为"疱疹?",遂自行停止化     

黄体酮局部注射致臀部异物肉芽肿一例

患者女,31岁。因双侧臀部包块伴疼痛1年余就诊于中国医科大学附属第一医院皮肤科。患者1年前自觉左侧臀部疼痛,曾于我科就诊,行局部超声检查未见异常,未予特殊处理。后右侧臀部亦出现疼痛,9个月前来院复诊,局部超声检查示,右臀部脂肪层回声增高伴极低回声,不除外脂膜炎伴局部液化改变……     

成人Kaposi水痘样疹3例

<正>1临床资料例1.女,22岁。因面部密集水疱伴痒痛7 d于2013年5月8日入院。患者7 d前口周出现数个米粒大水疱,自觉轻微瘙痒、刺痛,未予以治疗,随后患者左侧面颊部出现类似水疱,瘙痒疼痛剧烈,当地医院诊断为"过敏性皮炎",予以抗过敏及止痛药后,疼痛稍缓解,但皮疹渐增多,并累及右侧面颊部、额部,遂于我院就诊。体格检查:生命体征正常,系统检查未发现异常,既往史:1个月前面部皮肤反复过敏。皮肤科检查:皮     

结节性恶性黑素瘤伴发肺转移一例

临床资料患者,女,49岁。主因右侧腰部红斑结节5个月,伴疼痛3个月就诊于我院。5个月前无明显诱因右侧腰部出现一约黄豆大粉色结节,无任何症状;患者未行处理,2个月后,原发皮损周围出现类似结节,结节渐增大,颜色变为紫红色,伴有明显疼痛,3周前,结节疼痛加重,颜色变为紫黑色,就诊于当地县医院,超声提示：皮脂腺囊肿,建议行手术切除治疗,术中未发现囊肿组织,术后组织送我院病检。     

界线类偏结核样型麻风伴I型麻风反应1例

患者男,53岁.因左眶及周围红斑2年,水肿伴疼痛4个月就诊.2年前无明显诱因于左侧眶上出现一约指甲盖大小的红斑,伴轻微痒感.自用皮炎平后,红斑曾一度消失,不久又重新出现,且皮损不断扩大,并逐渐隆起.曾到当地县皮防站就诊,诊断不明.4个月前,皮损迅速向周围扩大,累及左额、左侧眼周等部位,并伴有麻木感及针刺样疼痛.1个月前到当地某医院皮肤科就诊,拟诊为Sweet病,给予相应治疗(不详),效果欠佳.其后在某省级医院皮肤科初步诊断为结节病或Sweet病,转诊至山东省皮肤病医院做组织病理检查,确诊为麻风病.患者既往史、个人史无特殊,家族中无麻风病人.     

小汗腺导管癌伴颅骨浸润一例

患者男,60岁,因头皮肿物2年余,于2017年2月3日就诊。患者2年前右枕部外伤后头皮出现直径约2 cm的皮色肿物,头颅CT提示右侧头皮血肿,未治疗。之后该肿物逐渐增大,并出现红肿、破溃、流脓,无出血,就诊于某医院,考虑痤疮,予抗炎治疗,肿物稍变小,但未消退,并逐渐出现萎缩、硬化。患者9个月前在某医院行皮损病理检查,真皮内少许基底细胞样上皮细胞团块,未予处理。近1个月来肿物明显扩大,触碰后间断出血。自发病以来饮食、睡眠、大小便尚可,体重无明显变化。既往体健,否认系统性疾病史,否认家族成员类似疾病史,否认用药史及过敏史,否认原发性肿瘤史……     

成人线状IgA皮肤病一例

患者男,22岁,背部水疱伴瘙痒1年半,泛发全身5个月.1年半前无明显诱因背部出现水疱,6个月后皮损渐延及小腹、前胸,伴瘙痒,曾于多家医院治疗效果欠佳.5个月前,因水疱泛发全身,剧痒,影响睡眠而来我院就诊,患者拒行病理检查及住院治疗,给予雷公藤、卡介苗素等治疗1个月,部分皮损消退,但时有新疱发生.1个月前上腭出现一绿豆大小水疱.2004年5月12日再次就诊,以大疱性类天疱疮收住院.     

皮肤窦性组织细胞增生症一例

患者,女,44岁。主因全身反复皮下结节伴瘙痒1年,于2009年2月10日就诊。患者1年前无明显诱因于左侧大腿处出现皮损伴瘙痒,随后右大腿外侧、右腰部、右臀部、耳前、左上臂、左腋后部位先后出现类似皮损,皮损周围出现瘀斑,触之有硬结。当地医院行皮损组织病理检查,诊断为黄色肉芽肿,未行特殊治疗。     

红癣2例

例1.男,15岁.阴阜左侧出现红斑、鳞屑,伴瘙痒2个月,于2007年5月26日就诊.患者2个月前阴阜左侧出现红斑,伴有轻度瘙痒,未予治疗.平素无糖尿病等慢性疾病.皮肤科检查:阴阜左侧见一约手掌大小红斑,边界清楚,形状不规则,表面覆细薄鳞屑,阴毛正常(图1).     

艾滋病合并梅毒、带状疱疹1例

<正>1临床资料患者男,36岁。因四肢掌跖红斑2周,腰腿部水疱伴疼痛1 d,于2017年5月29日就诊于常州市常武太湖医院皮肤科。患者2周前四肢掌跖出现红斑,就诊于当地医院,因患者在服用治疗艾滋病药物,故疑诊"药疹",遂给予抗过敏治疗,未见明显改善,1 d前左侧腰腿部出现水疱伴疼痛,遂到我院就诊。既往史:患者3个月前于本市疾病控制中心确诊人类免疫缺陷病毒(HIV)抗体阳性。开始服用奇     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.