象限性色素性紫癜性皮病1例

患者男,50岁。左大腿外侧瘀点和瘀斑5月余。皮损组织病理示:表皮轻度角化过度,基层灶性液化,真皮浅层胶原纤维增生,毛细血管扩展充血,血管周围可见单核细胞、淋巴细胞浸润及外溢的红细胞及含铁血黄素。诊断:象限性色素性紫癜性皮病。     

节段性金黄色苔藓4例

报告4 例节段性金黄色苔藓.3男1 女,年龄18～41 岁.4 例患者均有典型的金黄色苔藓的皮损,位于四肢,呈节段性分布.组织病理检查显示表皮正常,真皮浅层有致密的淋巴细胞呈带状浸润,并有红细胞溢出.真皮浅层有含铁血黄素沉积.临床上,该病需与其他色素性紫癜性皮病鉴别.     

表现为多灶性皮损的腋窝乳房外Paget病

报告1例表现为多灶性皮损的腋窝乳房外Paget病(extramammary Paget's disease, EMPD),并回顾性分析国内报道的14例类似患者。患者女,60岁,右侧腋窝红斑、鳞屑伴瘙痒20年。皮损组织病理检查示表皮角化过度,棘层增生,表皮内可见核大深染、胞浆丰富的肿瘤细胞,排列紊乱,成群分布。诊断:乳房外paget病。     

过敏性紫癜合并急性播散性脑脊髓炎

报告1例过敏性紫癜并发急性播散性脑脊髓炎。患者女,31岁。躯干及四肢反复瘀点和瘀斑2余年。体格检查:双侧眼球外展受限,颈软,肌力和肌张力均正常,脑膜刺激征(-),双侧Chaddock征(+),右侧抓握反射(+)。皮肤科检查:四肢、腹部、腰部及背部多发对称性分布的紫红色斑疹及斑丘疹,部分融合成片,皮损压之不褪色。皮损组织病理检查:表皮大致正常;真皮浅中层细血管周围及胶原束间小片状淋巴细胞浸润,伴稍多中性粒细胞及核尘,部分血管管壁模糊,可见红细胞漏出。头颅磁共振成像(MRI)示两侧大脑半球、基底节区及右侧桥臂多发脱髓鞘病变。诊断:过敏性紫癜合并急性播散性脑脊髓炎。     

大疱性疥疮

报告1例大疱性疥疮。患者男,65岁。3个月前无明显诱因躯干、四肢出现散在红斑、水疱、糜烂、结痂,伴瘙痒。患者1个月前指缝间、阴囊处出现类似红斑、丘疹,瘙痒明显。皮肤科检查:躯干、四肢可见弥漫性红斑,部分红斑上可见紧张性水疱,疱壁紧张,疱液清亮,部分水疱破裂后糜烂,可见红色糜烂面,部分表面结痂;双手指缝间、阴囊散在红斑,苔藓样变,可见抓痕。皮损组织病理检查:(左股内侧皮损)角化不全,浆液渗出,可见表皮下疱,疱内可见浆液,大量嗜酸性粒细胞及红细胞,真皮浅层可见嗜酸性粒细胞及中性粒细胞浸润;直接免疫荧光:皮肤全层未见特异性荧光,间接免疫荧光:真皮与表皮交界处(-);镜检发现疥螨。诊断:大疱性疥疮。     

物理性皮肤病

20131502日光性弹性组织变性综合征合并光线性角化病一例/孙怡(潍坊市医院皮肤科),王振华,王玉坤∥中华皮肤科杂志.-2013,46(4).-285~286患者女,60岁。左面部角化性斑块及粉刺4年。1年前皮损明显扩大并出现瘙痒。皮肤科检查:左颧部近外眦处见淡褐色类圆形斑块,由多个米粒大小的结节融合而成,结节顶端见较大的开口粉刺及黑头粉刺皮损表面明显角化过度,可见黏着性鳞屑,多皱呈橘皮样外观,轻度红肿。皮损组织病理:表皮部分区域萎缩,棘层部分轻度肥厚,表皮突增生,表皮近基底层可见排列紊乱的不典型细胞,扩大的毛囊漏斗内见板层     

表现为发疹性瘙痒性丘疹的汗孔角化病

报告1例表现为发疹性瘙痒性丘疹的汗孔角化病.患者男,50岁.臀部丘疹伴剧烈瘙痒7年,逐渐融合成斑块,丘疹突然增多并累及双下肢1年.皮损组织病理检查符合汗孔角化病.给予角质剥脱剂外用及阿维A口服治疗4周,皮损暂无明显改善.     

外生殖器部位的棘层松解性皮病

报告1例发生于外生殖器部位的棘层松解性皮病.患者女,311.外阴、肛周出现灰白色丘疹6个月,无明显疼痛、瘙痒等不适,部分皮损轻度糜烂、结痂.皮损组织病理检查:表皮灶性角化过度、角化不全,棘层肥厚,棘细胞松解,角化不良.表皮下血管增生,淋巴细胞浸润,直接免疫荧光检查阴性.     

表皮松解性棘皮瘤

报告1例表皮松解性棘皮瘤.患者女,44岁.外阴丘疹缓慢增大伴瘙痒2个月余.系统检查无异常.皮损组织病理检查示表皮角化过度,棘层肥厚,表皮局灶性颗粒变性.诊断为表皮松解性棘皮瘤.手术切除皮损.     

嗜酸性肉芽肿性多血管炎

报告1例嗜酸性肉芽肿性多血管炎(EGPA)。患者男,27岁。双足背红斑伴瘙痒半年,双下肢环形瘀斑及结节2个月。既往支气管哮喘及过敏性鼻炎病史4个月。皮肤科检查:双足背散在红斑,双下肢多发黄豆至鸡蛋大结节,浸润明显,表面可见紫癜样改变,部分皮损呈环状,少数皮损破溃及结痂。实验室及辅助检查:总IgE 712 kIU/L,嗜酸性粒细胞(EOS)计数3.0×109/L,白细胞分类:EOS 0.29。抗核抗体(ANA)、抗中性粒细胞胞质抗体(ANCA)及抗髓过氧化物酶抗体(Anti-MPO)均(-)。鼻窦CT:鼻窦炎。肌电图:双下肢周围神经中度受损,双下肢感觉神经中度受损。下肢血管超声:右侧足背动脉闭塞。皮损组织病理检查:血管周围及皮下脂肪组织可见大量EOS浸润,局部区域可见嗜酸性肉芽肿结构。诊断:EGPA。     

银杏达莫注射液治疗过敏性紫癜的疗效分析

目的比较银杏达莫注射液与糖皮质激素治疗过敏性紫癜的疗效。方法对贵阳医学院附属医院2003年1月-2008年5月收入院治疗的68例过敏性紫癜病人的临床资料进行回顾性分析,分为治疗组30例(杏丁注射液)和对照组38例(糖皮质激素)。比较两组的有效率和复发率及紫癜性肾炎的发生率。结果治疗组痊愈20例,显效8例,好转1例,无效1例,有效率93.33%;对照组痊愈24例,显效4例,好转7例,无效3例,有效率73.68%。随访半年,治疗组复发3例(10.71%),对照组复发12例(42.86%)。治疗组无1例发生紫癜性肾炎,而对照组有3例(7.89%)。两组患者的有效率比较,治疗组高于对照组,复发率比较,治疗组低于对照组,差异均有统计学意义(P均0.05);但两组患者中紫癜性肾炎的发生率比较,差异无统计学意义(P0.05)。结论银杏达莫注射液治疗过敏性紫癜的疗效显著,复发率低,值得临床推广应用。     

A Case of Sj?gren's Syndrome That Presented with Alcohol-induced Purpura

Sjögren syndrome (SS) is a systemic autoimmune disease that mainly affects the salivary and lacrimal glands. It may exist as a primary condition or in association with other systemic autoimmune diseases. Patients with SS usually complain of persistent dryness of the mouth and eyes and other features, including diverse general symptoms and cutaneous symptoms such as purpura. We report here on a case of 34-year-old woman who presented with purple non-blanching palpable purpura on both lower legs, and these lesions had developed soon after drinking alcohol 2 days previously. She had a 2 year history of repeatedly developing rashes in association with drinking alcohol. The physical examination showed dry eyes and dry mouth. The laboratory tests showed positivity for anti-Ro/SS-A antibody and RF and hyperimmunoglobulinemia. She was diagnosed as suffering with primary SS. Herein we report on a patient with primary SS and this patient initially presented with recurrent purpura in association with alcohol ingestion. Drinking alcohol had played a role as a possible aggravating factor for the cutaneous purpura of this patient with SS.     

过敏性紫癜患者血清丙二醛、总抗氧化能力和黄嘌呤氧化酶检测及意义

目的:检测过敏性紫癜(HSP)患者血清丙二醛(MDA)水平、总抗氧化能力(T-AOC)及黄嘌呤氧化酶(XOD)活性的变化,并观察其与HSP病情的关系.方法:应用比色法检测36例患者血清MDA的水平、T-AOC及XOD活性.16名健康儿童作对照.结果:与对照组相比,HSP患者急性期MDA水平和XOD活性明显升高,T-AOC明显降低,差异有统计学意义(P<0.01);且患者病情临床评分与MDA水平呈显著正相关(P<0.05),与T-AOC活性呈显著负相关(P<0.01).结论:检测HSP患者血清中MDA水平及T-AOC活性变化能反映HSP患者的氧化应激状态;可作为评估HSP患者病情的指标.     

复方甘草酸苷联合一清胶囊治疗单纯型过敏性紫癜66例疗效观察

目的评价复方甘草酸苷联合一清胶囊治疗单纯型过敏性紫癜的临床疗效。方法将126例患者随机分为两组。两组均口服氯雷他啶、芦丁片、潘生丁和一清胶囊,治疗组同时予静滴复方甘草酸苷。连续治疗2周后判定疗效。结果治疗组与对照组有效率分别为89.39%和70.00%,差异有统计学意义(P<0.05)。结论复方甘草酸苷联合一清胶囊治疗单纯型过敏性紫癜疗效确切,值得临床选用。     

过敏性紫癜患者外周血Th17/Treg细胞平衡性检测

目的 探讨Th17细胞/Treg细胞（CD4+CD25+ Foxp3+ T细胞）失衡在过敏性紫癜（HSP）发病机制中的作用。方法 采用流式细胞仪检测59例HSP患儿外周血Th17细胞和Treg细胞的比例、实时定量RT-PCR检测Th17细胞与Treg细胞转录因子RORγt、Foxp3 mRNA的表达。同时以38例性别、年龄匹配的健康儿童做对照。结果 HSP组外周血Th17细胞比例（CD4+IL-17+/CD4+ T细胞,1.87% ± 0.56%）及RORγt mRNA表达量（7.71 ± 1.95）,均显著高于正常人对照组（CD4+IL-17+/CD4+ T细胞：0.39% ± 0.15%,P < 0.01; RORγt mRNA：1.49 ± 0.57,P < 0.01）;HSP组外周血Treg细胞比例（CD4+CD25+Foxp3+/CD4+ T细胞,1.63% ± 0.44%）及Foxp3 mRNA的表达量（0.34 ± 0.11）,均明显低于正常人对照组（CD4+CD25+Foxp3+/CD4+ T细胞：5.04% ± 1.44%,P < 0.01;Foxp3 mRNA：1.71 ± 0.69,P < 0.01）。HSP各组间Th17细胞、Treg细胞比例及RORγt、Foxp3 mRNA的表达量差异无统计学意义（P > 0.05）。结论 过敏性紫癜患者外周血Th17、Treg细胞水平及其转录因子表达量发生变化,其比例的失平衡可能参与过敏性紫癜的发病。     

表现为皮肤紫癜的巨细胞病毒病

报告1例表现为皮肤紫癜的巨细胞病毒病.患者男,31岁.头痛、发热10 d,躯干、四肢出现紫癜和丘疹5 d.实验室检查示单核细胞增生,血小板减少,嗜异性凝集试验阴性,抗巨细胞病毒抗体(抗CMV-IgM)阳性.诊断:巨细胞病毒病.     

Acute kidney injury due to bilateral ureteral obstruction in children

Bilateral ureteral obstruction in children is a rare condition arising from several medical or surgical pictures. It needs to be promptly suspected in order to attempt a quick renal function recovery. In this paper we concentrated on uncommon causes of obstruction, with the aim of giving a summary of such multiple, rare and heterogeneous conditions joint together by the common denominator of sudden bilateral ureteral obstruction, difficult to be suspected at times. Conversely, typical and well-known diseases have been just run over. We considered pediatric cases of ureteral obstruction presenting as bilateral, along with some cases which truly appeared as single-sided, because of their potential bilateral presentation. We performed a review of the literature by a search on PubMed, CrossRef Metadata Search, internet and reference lists of single articles updated to May 2014, with no time limits in the past. Given that we deal with rare conditions, we decided to include also papers in non-English languages, published with an English abstract. For the sake of clearness, we divided our research results into 8 categories: (1) urolithiasis; (2) congenital urinary tract malformations; (3) immuno-rheumatologic causes of ureteral obstruction; (4) ureteral localization of infections; (5) other systemic infective causes of ureteral obstructions; (6) neoplastic intrinsic ureteral obstructions; (7) extrinsic ureteral obstructions; and (8) iatrogenic trigonal obstruction or inflammation. Of course, different pathogenic mechanisms underlay those clinical pictures, partly well-known and partly not completely understood.     

A case of Henoch-Schonlein purpura temporarily improved by hemodialysis

We report a case of Henoch-Schonlein purpura that occurred in an adult patient with end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD). The patient's skin lesions clearly decreased in number during HD, but not during CAPD. This finding has not been previously reported.