肾癌皮肤转移1例

肾癌发生皮肤转移在临床上较为少见,现将笔者诊治的1例报告如下. 患者男,73岁.因胸部皮肤出现紫红色结节伴疼痛2年,于2007年5月14日就诊.2年前患者因肾透明细胞癌行外科根治术.当时即发现胸部皮肤有一结节,未引起重视.2年间结节呈缓慢增长,偶有疼痛.     

肺癌皮肤转移1例

患者男,65岁.因右侧胸部、背部皮下结节伴全身多处疼痛半年,于2008年4月29日来我科就诊.患者半年前不明原因全身多处疼痛,右侧胸壁出现绿豆大皮下结节,无明显自觉症状.半年来右胸壁皮下结节逐渐增大,并于1个月前右侧上背部出现3个粟粒大皮下结节.患者自发病以来,无胸闷、乏力、咳嗽、体莺减轻,无吸烟史.     

鲍温病并皮肤念珠菌病1例

患者女,56岁,哈尼族,因右背部发生斑块、结节伴疼痛3年,破溃2月余于2008年11月15日来诊。患者3年前无原因感右背部发生红斑、结节伴疼痛,一直未进行治疗。3月前到民间医生处行拔火罐、挑治及外敷草药3次后约10天,皮损破溃、疼痛加剧。     

多发性皮肤平滑肌瘤1例

<正>1临床资料患者女,34岁。因左侧颈、肩部及双上肢伸侧出现结节并逐渐增多伴疼痛34年,加重1年就诊。患者生后即发现左侧颈部2个米粒大小的结节,未引起重视。此后29年,左侧颈部小结节渐增至黄豆大,时有自发性疼痛,左肩部及双上肢伸侧相继出现百余个皮色至红褐色梭形小结节,有挤压痛。近5年皮损数量及大小无明显变化。近1年左侧颈部2个小结节自发性疼痛强度及发生频率明显加剧,尤以冬     

左下肢多发性皮肤平滑肌瘤并发子宫肌瘤1例

患者女,36岁.因左下肢多发性硬性丘疹及结节5年余,加重伴疼痛1年来我院就诊.患者5年前无明显诱因左下肢小腿外侧出现数个米粒大红色丘疹,逐渐增多,无不适.曾在当地按"湿疹"予以治疗,未见好转.近1年来皮疹明显增多变大,常感阵发性疼痛,遇冷或受压加剧,影响睡眠.饮食及二便未见异常.患者曾两次行"子宫肌瘤切除术",现月经量仍偏多,伴血块和轻度腹痛感,经期较长,父母体健,家族中无类似疾病患者.     

溃疡性结肠炎并发坏疽性脓皮病1例

1 病历摘要 患者男,45岁.间断脓血便伴双足皮肤损害2年,于2008年6月于我院消化科住院治疗.患者2006年8月无明显诱因出现大便带脓血,每日二三次,每次100-150 mL,未诊治.脓血便进行性加重,伴腹胀及排便不尽感,次数增至每日5～7次;同时双踝及足背出现多个黄豆至蚕豆大结节,结节破溃后融合成无痛性溃疡.于外院行结肠镜检查诊断为溃疡性结肠炎.经泼尼松40mg/d、柳氮磺吡啶3g/d、双歧三联活菌420mg每天3次,及左氧氟沙星400 mg/d联合治疗后脓血便量及次数逐渐减少,皮肤溃疡随之愈合.     

单发皮肤猪囊虫病1例

临床资料患者,男,22岁。主因左前胸出现皮下结节1年余,于2010年12月1日来我科就诊。患者1年前无明显诱因左前胸出现皮下结节,未予以治疗,结节逐渐增大。既往体健。无牧区生活史,否认食用生肉及米猪肉史。体格检查:各系统检查未见明显异常。皮肤科情况:左前胸可触及1个约2.0cm×1.5cm大小的结     

周围神经鞘瘤1例

神经鞘瘤又名Schwann细胞瘤(Schwannoma),是由周围神经的Schwann鞘所形成的肿瘤.可自然发生,也可能为外伤或其它刺激的结果.我科近期诊治1例,现报道如下. 临床资料 患者女,71岁.左上肢结节不适60年,疼痛加剧2年.患者60年前行疫苗接种,在接种部位出现一结节.随年龄的增长结节缓慢增大,并有轻压痛,一直未治疗,近2年疼痛略明显.患者诉既往有冠心病、心衰病史,否认糖尿病史.体检:T 36.5℃,P 76次/min,R 18次/min,BP 145/85 mmHg.     

结节性发热性非化脓性脂膜炎并发复发性阿弗它口炎1例

患者男,38岁.因躯干、四肢皮肤反复出现暗红色疼痛性结节伴发热6个月,于2005年4月收住院.6个月前,患者无明显诱因双侧大腿皮肤出现数个黄豆大暗红色结节,伴疼痛,间断发热,体温波动在37.5～39℃.皮损渐增多、扩大.     

皮下曼氏裂头蚴病1例

<正>1 病历摘要患者女，65岁。因四肢散在皮下结节15年，于2020年9月10日来我科就诊。患者15年前左大腿开始出现皮下结节，皮温及颜色正常，未诊治，四肢亦逐渐出现皮下结节，时有缩小及扩大，2年前于外院疑诊“脂肪瘤？纤维瘤？”，未治疗，现最大结节位于左大腿内侧，病程中结节无明显疼痛，无头疼及恶心等。     

Peripheral T-cell lymphoma presenting as lipoatrophy and nodules

BACKGROUND: Cutaneous lymphomas have many morphologic forms and clinical features. Lymphoma presents rarely with a constellation of nodules, panniculitis, and localized lipoatrophy. The histopathologic similarities of lymphoma and connective tissue disease panniculitis may create a diagnostic challenge. METHODS: We retrospectively reviewed the case of a 47-year-old man who presented 15 years earlier with recurrent fevers, fatigue, tender subcutaneous nodules, and facial, trunk, and extremity lipoatrophy. RESULTS: Initial biopsy of a cutaneous nodule showed lymphohistiocytic panniculitis without atypical inflammatory cells. Serologic tests showed negative connective tissue serologies, yet the initial clinical impression was most consistent with lupus panniculitis. Initially, the patient was treated with oral prednisone; later, steroid-sparing agents were used with modest improvement evidenced by resolution of his systemic symptoms and stabilization of the cutaneous findings. A decade later, more pronounced facial lipoatrophy, new facial nodules, and posterior thigh pain developed. Laboratory testing showed leukopenia, elevated liver and muscle enzymes, hypertriglyceridemia, and a low level of high-density lipoprotein. Biopsy of a new chin nodule indicated peripheral T-cell lymphoma, whereas an evaluation for systemic malignant involvement was negative. The patient was started on chemotherapy, which resulted in stabilization of the lipoatrophy and decreasing size and frequency of the cutaneous nodules, but the posterior thigh pain persisted. CONCLUSIONS: We report a rare case of lymphoma presenting as nodules and profound lipoatrophy, which exemplifies the complexity of lymphomas. Profound lipoatrophy and panniculitis may be an unusual and diagnostically challenging presentation of cutaneous lymphoma.     

伴有皮肤表现的急性单核细胞白血病1例

患者男,30岁。反复发热伴全身酸痛1月余,全身无症状结节、肿块1周。皮肤科情况:面部、躯干、四肢多发浸润性青色或灰色结节和肿块,最大者4.0cm×2.5cm,质韧,无压痛。结合血液学检查,皮肤组织病理及免疫组化检查,诊断为急性单核细胞白血病(M5型),皮肤白血病。本例患者提示,皮肤科医生对于无症状皮损,应考虑内脏肿瘤的可能。     

Localized Ehlers-Danlos syndrome.

A 34-year-old woman had the cutaneous features of the Ehlers-Danlos syndrome, which was strictly limited to the skin and subcutaneous tissue in the region of the left shoulder. The disorder started at approximately age 22 with the development of subcutaneous nodules. Hyperextensibility of the skin in this region developed within the subsequent five years. There was a notable lack of the usually associated joint hyperextensibility, bleeding tendency, scar formation, or the serious systemic components of the Ehlers-Danlos syndrome.     

Cutaneous metastatic adenocarcinoma

A 55-year-old male presented with asymptomatic nodules and plaques on his scalp and pubic region of 2 months' duration. He was having productive cough, haemoptysis, chest pain, anorexia and weight loss and receiving antitubercular treatment for these symptoms for last 3 months. Clinical diagnosis of cutaneous metastatic disease was made. Chest x-ray revealed multiple coin shaped shadows on both sides with pleural effusion. Routine investigations were normal except for anemia and hyperuricemia. Biopsy of skin nodules showed features of metastatic adenocarcinoma. Features and significance of cutaneous metastases are discussed.     

Primary cutaneous marginal zone lymphoma treated with doxycycline in a pediatric patient

We present the third reported case of a primary cutaneous marginal zone lymphoma (PCMZL) treated with doxycycline in a pediatric patient with negative serology for Borrelia burgdorferi. A 14-year-old boy presented with multiple asymptomatic erythematous papules and nodules on his extremities and trunk which biopsy confirmed to be PCMZL. He was started on doxycycline and experienced a near-complete response. Given the favorable side effect profile of doxycycline and the indolent nature of PCMZL, we believe doxycycline is a possible therapy for PCMZL pediatric patients who have widely disseminated cutaneous disease.     

以皮肤表现首诊的胃癌一例并发皮肤转移癌临床分析

目的统计我院皮肤科病理室皮肤转移癌患者资料,分析其临床特点,加深对皮肤转移癌的认识。方法报告1例以皮肤表现首诊的胃印戒细胞癌,并综合2011年1月—2016年1月的皮肤转移癌资料,分析患者年龄、性别、皮损形态特征和发生部位等特点,以及原发肿瘤的类型及皮肤转移癌与原发肿瘤发生时间的关系。结果共统计皮肤转移癌14例,占我科皮肤病理室组织病理切片总数0.24%(14/5 955例),其中男5例(36%),女9例(64%),平均年龄(57.46±12.02)岁;9例女患者中,原发于乳腺癌7例(77.8%),胃癌1例,未明确原发灶1例;5例男患者中,原发于肺癌3例(60.0%),食管癌1例,未明确原发灶1例。所有患者中以皮肤表现为首发症状3例,皮肤转移癌首发率21.4%(3/14);11例患者表现为浸润性红斑及红斑基础上的丘疹、结节,2例表现为头皮孤立结节,1例表现为胸腹部多发结节。14例皮损均分布于头颈部及胸腹部。3例患者的免疫组化显示为低分化腺癌,其中1例经及时化疗后皮损基本消失,随访1年已临床痊愈。结论皮肤转移癌发生率低,以皮肤表现首诊的转移癌少见。对于皮肤转移癌早发现、早诊断、早治疗可一定程度改善预后。     

SLE并发播散性皮肤非典型分枝杆菌感染 1例

报告1例SLE患者并发孢子丝菌病样播散性非典型分枝杆菌原发皮肤感染，患者女性，33岁，水产经营者，既往有SLE病史15年。因“全身散发皮下红斑结节，破溃化脓伴轻痛2月”收住院。皮损散在分布于四肢和躯干。为大小不等的硬性结斑结节，中央破溃，脓性分泌物的黄色结痂。皮损组织液涂片找到抗酸杆菌。组织病理示真皮肉芽肿性炎症。用阿米卡星霉素和复方磺胺甲恶唑（SMZco)治疗1个月，大部分皮损消退好转。     

Histiocytosis X: a seven-year experience at a children's hospital

Thirty-two patients with histiocytosis X were evaluated and treated at Children's Memorial Hospital, Chicago, during the years 1978 to 1984. Twelve patients (38%) had solitary or multifocal bone lesions, three (9%) had bone lesions and diabetes insipidus, and seventeen (53%) had cutaneous and/or multisystem involvement. Age at diagnosis ranged from 2 days to 15 years. Fifteen patients were 2 years of age or younger at the time of diagnosis. Sixteen patients (50%) had skin infiltrates, of whom seven (43%) had cutaneous lesions documented at birth. Cutaneous lesions included vesicopustules, erythematous papules, nodules, eczematous dermatitis, granulomatous ulcerative lesions, petechiae, and hemorrhagic lesions. Xanthomas and nail dystrophy were not observed. The therapeutic regimen chosen was based on extent of involvement and location of infiltrates. Only two of the thirty-two patients died; both had multisystem disease.     

不规则毛霉致皮肤型毛霉病一例

患者,女,65岁。反复左上肢结节、斑块、流脓伴疼痛7年,累及右上肢1年。2型糖尿病病史3年。左手背皮损组织病理示表皮棘层肥厚伴角化不全,真皮全层多灶肉芽肿形成伴淋巴细胞、浆细胞浸润,胶原纤维变性,并累及皮下脂肪;真菌培养示白色绒毛状菌落生长,镜下表现为粗大、无分隔菌丝,可见圆形孢子囊;宏基因组测序示不规则毛霉。诊断为不规则毛霉致皮肤型毛霉病。