以皮肌炎为首发症状的胸腺瘤一例

61岁男性患者,面部红斑6个月、加重泛发四肢伴四肢肌肉酸痛3个月。双上肢肌力Ⅳ级,双下肢肌力Ⅳ级。皮肤科情况:双眼睑水肿性紫红斑,全身泛发水肿性紫红色鳞屑性斑片,指关节伸侧可见紫红色扁平Gottron疹。胸部计算机断层增强扫描示:前纵隔肿瘤。纵膈肿物切除术后行组织病理检查,结果示前纵隔胸腺瘤(B2型)。诊断:①皮肌炎,②胸腺瘤。     

皮肌炎合并鼻咽癌1例报告

患者，男，44岁，司机。因面部进行性紫红色斑片15月，伴四肢乏力11月，于2003年2月5日入院。患者于2001年10月底在温泉浴后数天，面部和后颈部外始出现小片红斑。曾于2001年12月初来我院求治，当时按过敏性皮炎治疗无效，继而又在省中医院按光敏性皮炎接受中西药联合治疗，服泼尼松10mg bid，羟氯喹0.1bid及中药汤剂，仍无效。随后，红斑逐步     

以荨麻疹样皮损为首发症状的皮肌炎1例

临床资料　患者女,30岁,农民。因全身起风团、时发时退、轻度瘙痒4年,近2周持续高热(Ｔ38℃～39℃),咽喉疼痛,皮疹增多伴乏力而以感染性荨麻疹收入院。患者4年前无明显诱因于面部、胸背部、四肢突然出现大量红色风团,伴有瘙痒。在当地医院以“急性荨麻疹”注射葡萄糖酸钙和扑尔敏针剂,3天后缓解。此后每年6月～8月照射太阳光后,面部、颈胸部、两前臂、手背等暴露部位皮肤发红。曾以“慢性荨　上海市杨浦区中心医院皮肤科,200090麻疹”服用息斯敏、酮替芬,症状无改善,皮疹无好转。体检:Ｔ39℃,Ｐ90次/ｍｉｎ,Ｒ20次/ｍｉｎ,ＢＰ16/11ｋＰａ。…     

以红斑水疱为首发临床表现的皮肌炎

报告1例以红斑水疱为首发表现的皮肌炎。患者女,20岁。因面部、躯干及四肢水肿性红斑伴瘙痒20余天,水疱2 d入院。入院后查肌酶及IgE均升高,肌电图提示肌源性损害。右胫前肌肉组织病理检查示部分肌纤维空泡变性。免疫组化示CD68(+)。诊断:皮肌炎。     

皮肌炎合并鼻咽癌1例

患者男，45岁。面颈部、背部红斑2年，鼻塞、鼻流血伴四肢乏力1年余。2年前患者无明显诱因出现面颈部红色斑疹，自觉瘙痒，未引起重视，后逐渐发展至整个面部、后背部及四肢伸侧，并出现皮肤红肿，颜色逐渐加深。查肌电图示：肌源性损害（活动期），肌酶谱：乳酸脱氢酶333U／L，羟丁酸脱氢酶263U／L，抗核抗体：1：160（H），诊断为皮肌炎。     

以副肿瘤皮肌炎为首发症状的骨髓增生异常综合征1例

临床资料患者男,67岁。于2005年6月无明显诱因出现面部及四肢皮肤红斑,伴痒痛。外院诊为“瘙痒症”,予“康体多”等治疗后皮损有所好转。但手足肿胀,查血象WBC28.7×109/L,给予头孢拉定抗感染治疗18天无效,全身再次皮肤红肿,于我院皮肤科就诊,经皮肤活检为非特异性炎症。骨髓增生明显活跃,符合感染骨髓象。血片中WBC明显增高,分类单核细胞占20%,嗜酸粒细胞4%,中晚幼粒细胞3%。ESR26mm/h;风湿系列无异常,CRP<8mg;ANCA及ANA均阴性。肝功ALB34.6g/L,TBIL28.3μmol/L,IBIL20.7μmol/L,DBIL7.6μmol/L,余均正常。经南京市鼓楼医…     

以肺部症状为首发的皮肌炎1例

以肺部症状为首发的皮肌炎１例陈大火昆①患者男，５４岁，因反复发热伴咳嗽、咳痰８个月，面部红肿１个月于１９９５年９月７日收住院。８个月前患者感冒后体温３８℃左右，咳嗽，咳白色泡沫状痰，偶有黄色泡沫，从未有血丝。曾在外院诊为“肺炎、支扩、肺癌待排”，予先...     

以脂膜炎为临床表现的皮肌炎1例

脂膜炎是皮肌炎一种罕见的临床表现,以红斑性硬结或斑块为特征,伴或不伴有溃疡[1].现将笔者诊治的1例报告如下.     

以脂膜炎为皮肤表现的皮肌炎1例

报告1例以脂膜炎为皮肤表现的皮肌炎。患者男,20岁。14岁起四肢近端肌力下降,伴面部红斑。1年后大腿出现疼痛性结节,伴吞吐咽困难。组织病理学检查示小叶性脂膜炎伴淋巴细胞,浆细胞浸润。经参剂量糖皮质激素及环磷酰胺、静脉滴性丙种球蛋白治疗后肌炎及脂膜炎病情均缓解,提示脂腊炎可能是炎症性肌病的一个皮肤特征。     

以皮肤异色症为首发症状的皮肌炎1例

正1临床资料患者男,22岁。面颈部、前胸及双手背红褐色斑5年。5年前患者面部及双手背出现淡红色网状斑片,在当地医院考虑花斑癣,给予抗真菌药物萘替芬酮康唑治疗,效果差。2年前颈部、前胸及背部出现红褐色斑片,自诉与日晒、季节无关,且无肌力减退,曾去浙江某医院就诊,化验结果提示:肌酶增高(具体结果不详),诊断皮肌炎,未治疗。患者反复多次就诊于多家医院,口服多种药物(具     

无肌病性皮肌炎一例

患者,女,21岁。面部、躯干、四肢皮肤红斑、丘疹伴脱发6年,皮损基本损害为红斑,双眼睑见明显水肿性紫红斑,其他部位皮损为弥漫性对称性暗紫红色斑,双手可见Gottron丘疹。肌力正常。皮损组织病理检查：表皮轻度角化过度,基底膜增厚,真皮浅层水肿,血管周围单一核细胞浸润。诊断：无肌病性皮肌炎。给予泼尼松联合甲氨蝶呤治疗2个月后皮损明显好转。     

Malignancies associated with dermatomyositis and polymyositis in Taiwan: a nationwide population-based study

Background  Previous studies showed that idiopathic inflammatory myopathies (IIM) carried an increased risk of cancers. However, no large-scale study of IIM has been conducted in the Chinese population.
Objectives  We sought to delineate the association of IIM and various cancer types from a nationwide database in Taiwan.
Methods  We analysed the published national data from records of National Health Insurance claims. Cases of dermatomyositis (DM) and polymyositis (PM) from 2000 to 2005 and cancers registered in the catastrophic illness profile from 1997 to 2006 were collected. A nationally representative cohort of 1 000 000 enrollees was included for comparison.
Results  In total, 136 patients (12·8%) among 1059 cases of DM and 46 persons (7·0%) among 661 cases of PM carried internal malignancies. Patients with DM tended to have cancers of nasopharynx, lung and breast. On the other hand, patients with PM tended to have breast, uterine cervix and lung cancers. Compared with the general population, DM gave a 10-fold increased risk for cancers, in which a 66-fold increased risk for nasopharyngeal carcinoma and a 31-fold increased risk for lung cancer were the two most significant. For patients with PM, a 6-fold increased risk for cancer was observed. Juvenile DM had a 16-fold increased risk for haematopoietic or lymphoid malignancy. Two thirds of comorbid malignancies were detected shortly after the diagnoses of IIM, within a mean of 1–2 years. Overall, younger patients with IIM carried the highest risk for malignancies, especially those in their twenties and thirties.
Conclusions  This is the first large-scale study to report the associated malignancies and the cancer risk of IIM in Taiwan.     

无肌炎性皮肌炎并发鳞状细胞癌致上腔静脉综合征1例

报告1例伴发上腔静脉综合征的无肌炎性皮肌炎。患者男,61岁。反复双眼睑、面部、胸部紫红斑近2年,无明显肌肉症状,且逐渐出现上腔静脉回流受阻的表现,经实验室、CT及淋巴结组织病理学检查确诊为无肌炎性皮肌炎并发纵隔鳞状细胞癌致上腔静脉综合征。     

Wong型无肌病性皮肌炎一例

患者,女,72岁。头面颈部红斑、丘疹伴瘙痒16年,日晒后加重。实验室检查示：抗TIF1-γ抗体阳性。额部皮肤组织病理表现为表皮角化过度,局灶性角化不全和界面皮炎改变。结合患者典型皮肌炎皮肤表现和额部毛发红糠疹样皮疹,诊断为Wong型无肌病性皮肌炎。给予阿维A、海棠合剂、1%吡美莫司乳膏等治疗,病情逐渐好转。     

皮肌炎并发乳腺癌及乳房Paget病

报告1例并发乳腺癌和乳房Paget病的皮肌炎.患者女,51岁,右乳房出现肿物20余年,红斑、糜烂4年,面部及四肢红斑、丘疹伴肌痛2个月余,根据临床表现结合组织病理检查结果确诊为皮肌炎并发乳腺癌及乳房Paget病.     

Dermatomyositis and Nasopharyngeal Carcinoma

A nasopharyngeal carcinoma was diagnosed in a 37-year-old man with a two year history of dermatomyositis. The physical and laboratory examinations excluded further medical problems. To our knowledge, this is the first case of dermatomyositis associated with nasopharyngeal carcinoma in a white Israeli Jewish patient.     

以多形性皮损为首发表现的肺癌一例

患者,男,53岁。因＂全身皮肤红斑丘疹1个月,加重4天＂就诊。患者1个月前无明显诱因耳部出现红斑,未予重视,后皮疹稍有增多,当地医院间断使用地塞米松10 mg/d静滴1周,效果不佳,4天前双手背、肩背部及四肢出现红斑丘疹,数量明显增多、加重,诉肩背部皮疹无自觉症状,手背、下肢皮疹有疼痛感,无发热,关节疼痛等不适,无咳嗽咳痰等症状,尤畏光、乏力、肌肉疼痛,无吞咽、抬举、下蹲困难。     

糖皮质激素联合静脉用免疫球蛋白治疗老年皮肌炎2例

采用中等剂量糖皮质激素联合大剂量静脉注射用免疫球蛋白(IVIg)冲击治疗2例有糖皮质激素应用相对禁忌、且心肌酶谱非常高的老年皮肌炎患者。1例患者IVIg剂量为300mg/(kg·d),共5d,1例患者IVIg剂量为400mg/(kg·d),共4d。2例患者经治疗肌肉症状迅速缓解,心肌酶谱值在短期内降至正常,治疗中无明显不良反应。提示中等剂量糖皮质激素联合大剂量IVIg冲击治疗老年皮肌炎具有良好的疗效。     

Juvenile dermatomyositis: a statistical study of 114 patients with dermatomyositis.

We conducted a statistical review of 114 cases of dermatomyositis (DMS) treated primarily at the Department of Dermatology at Nagoya University Hospital over 27 years from 1965 to 1991 in order to determine the primary characteristics of juvenile DMS with the following results. 1) Juvenile DMS was found slightly more often in males than females; the male-to-female ratio was 1.4:1. Therefore, unlike adult DMS with its preponderance of females, there was no clear gender predominance. 2) Muscular manifestations tended to follow the appearance of cutaneous manifestations, but the frequency of minor muscular manifestations was high over the entire course of the disease. 3) Laboratory findings showed increases in serum aldolase and serum creatinine kinase with significant frequency when compared with adult patients (p < 0.01 and p < 0.05, respectively). Elevated serum aldolase most often occurred prior to or at the time of the appearance of muscular manifestations, suggesting its usefulness in early diagnosis. The positive rates for the antinuclear antibody on HEp-2 cells and anti-DNA antibody were significantly lower in children than in adults (p < 0.001 and p < 0.05, respectively). 4) There were no cases of juvenile DMS complicated by malignant tumors, interstitial pneumonia, or pulmonary fibrosis. There were also no deaths, and the rate of "remission or improvement" was significantly higher than in adult DMS cases (p < 0.05). Adult cases which remained the same or worsened usually presented with intractable muscular manifestations. In children, however, the cutaneous manifestations were more difficult to treat.(ABSTRACT TRUNCATED AT 250 WORDS)