反应性穿通胶原病1例

患者女性,52岁,表现为四肢散在有脐凹的角化性丘疹,有的中央有角栓。组织病理示胶原束以垂直方向穿通表皮。     

药源性皮肤病的组织病理模式分析

药源性皮肤病是临床上常见的一类反应性疾病,药物可以诱发各种不同的药源性皮肤病.组织病理学上,药源性皮肤病可以表现为各种炎症性反应模式.该文就药源性皮肤病的各种组织病理学反应模式进行总结分析.     

有口唇色素沉着表现的皮肤病

对有口唇色素沉着的皮肤病,如色素沉着一息肉综合征、Laugier-Hunziker综合征、Carney复合症、固定性药疹、吸烟者色素沉着斑等作一综述。了解这些疾病所具有的特殊形态有助于临床上更好地认识和鉴别有口唇色素沉着表现的疾病。     

有线状色素沉着表现的皮肤病

临床上一些色紊l生皮肤病表现为线状色素沉着,一些虽然不是色素性皮肤病,但也会出现线状色素沉着。该文综述了有线状色素沉着表现的皮肤病,如线状和漩涡状痣样过度黑素沉着病、线状Becker痣、线状持久性色素异常性红斑、带状黄褐斑、线状色素性紫癜性皮病、线状色素性扁平苔藓、线状皮肤红斑狼疮、线状硬皮病、Moulin线状萎缩性皮病等。     

获得性反应性穿通性胶原病一例

患者男,55岁,躯干、四肢泛发红丘疹伴痒4个月。就诊前4个月,患者因患糖尿病用艾塞那肽（exenatide）治疗后,躯干四肢出现广泛的红丘疹,逐渐增多,伴瘙痒,停药后皮疹未明显好转,遂到中国医学科学院皮肤病医院就诊。既往糖尿病史10年。否认家族中类似病史。体检：一般情况可,各系统检查未见明显异常。皮肤科检查：躯干、四肢见广泛针尖至绿豆大红色、红褐色丘疹,表面环状脱屑,部分丘疹中央见角栓或脐凹,可见Koebner现象（图1）……     

获得性反应性穿通性胶原病九例临床及病理分析

对2015年1月至2017年12月我院9例获得性反应性穿通性胶原病临床资料和组织病理进行回顾性分析。其中男女比例为1:1.25,平均发病年龄53.89岁,平均病程9.67个月,临床皮损形态多样,组织病理均可见变性的胶原纤维穿出表皮,有8例患者（88.9％）伴有糖尿病,2例患者（25%）伴有高血压。9例患者均被误诊为其他疾病,最易误诊为结节性痒疹 和湿疹或湿疹样皮炎 ,其余依次是皮肤血管炎 、坏疽性脓皮病 、皮肤溃疡、真菌感染、神经性皮炎、痒疹性大疱性类天疱疮、大疱性表皮松解症、扁平苔藓,均为1例次。     

皮肤病的牙齿表现

不少皮肤病可以合并各种不同的牙齿表现,这些表现应该为皮肤科医生熟悉。本文复习了这些表现,并指出认识和正确的评估这些牙齿的体征将能有助于帮助诊断和治疗不少的皮肤病。     

35例获得性反应性穿通性胶原病分析

本文对2013-2016年我院35例获得性反应性穿通性胶原病临床资料和组织病理进行回顾性分析,其中男女比例为1∶1.19,平均发病年龄49.5岁,病程长短不一,临床皮损形态多样,组织病理均可见胶原纤维穿出表皮,20%患者伴有系统性疾病,临床误诊率为77%,最易误诊为结节性痒疹(13例次)和湿疹(10例次)。     

嗜中性皮肤病

嗜中性皮肤病包括一组以中性白细胞浸润为组织病理特征的皮肤病,根据中性白细胞浸润的模式可将其分为表皮浸润为主、真皮浸润为主和皮下脂肪浸润几种组织病理类型.除皮肤损害外,嗜中性皮肤病尚可伴有皮肤外器官受累,常并发的系统性疾病包括血液系统恶性疾病、消化道疾病和慢性关节炎.     

皮肤病与幽门螺杆菌

近年来研究幽门螺杆菌 (ｈｅｌｉｃｏｂａｃ ｔｅｒｐｙｌｏｒｉ,ＨＰ)感染与皮肤病相关的文章报道逐渐引起皮肤科学界一些学者的关注 ,虽然有关的文献不多 ,但已有的研究表明ＨＰ感染与皮肤病 ,如酒渣鼻、慢性荨麻疹等可能有一定关联。为此我们回顾了近 10年来的有关文献 ,现概述如下。一、ＨＰ研究背景1983年Ｍａｒｓｈａｌｌ和Ｗａｒｒｅｎ从胃粘膜成功地分离出ＨＰ。 16年来 ,ＨＰ从发现到全球范围的深入研究 ,其与消化道疾病的关系已引起了医学界尤其是胃肠病学科界的广泛关注 ,并取得了许多重大成果。由于ＨＰ导致系统感染反应 ,目前…     

Perforating Granuloma Annulare Mimicking Papulonecrotic Tuberculid

Perforating granuloma annulare (PGA), a rare variant of granuloma annulare, is characterized by transepidermal elimination of altered collagen that clinically manifests an umbilicated papule with a central crust. It can be confused with papulonecrotic tuberculid (PNT) because of their similar appearance. Unlike PGA, PNT is usually related to tuberculosis infection with a typical histologic finding of wedge-shaped dermal necrosis. Here, we report the first Korean case of PGA mimicking PNT both clinically and histologically. A 43-year-old Korean woman presented with erythematous papules localized on the extensor surface of her limbs for one year. Some of these papules had a central umbilication or a crust. Regarding comorbidity, she had latent tuberculosis diagnosed with QuantiFERON®-TB Gold test about five months ago. She was on antituberculous medication. Initially, a diagnosis of papulonecrotic tuberculid accompanied by latent tuberculosis was considered. However, despite taking the antituberculous medication for five months, her skin lesions were not improved. Biopsy specimen from her arm lesion showed wedge-shaped area of necrosis in the dermis. Additionally, there were multiple focal mucin depositions and palisading granulomatous inflammation throughout the dermis. A diagnosis of PGA was made and she was treated with topical corticosteroid. After two weeks of applying topical corticosteroid, most of her skin lesions disappeared, leaving some hyperpigmented scars.     

Metastatic Crohn's disease in a boy presenting with genital swelling

Cutaneous manifestations of Crohn's disease are uncommon and occasionally can affect the genitals with varying symptomatology. When cutaneous features precede or occur in the absence of GI symptoms, this condition may remain undiagnosed. We report the case of a 14-year-old boy who presented for evaluation of persistent penile edema with clinicopathological features consistent with a diagnosis of genital metastatic Crohn's disease, successfully treated with infliximab.     

Recurrent sterile abscesses in a case of X-linked neutropenia

Cutaneous manifestations are common in monogenic immune disorders, including both infectious and non-infectious etiologies. We report follow-up of a case initially published in Pediatric Dermatology in 2001 of a 13-year-old boy with a history of inflammatory skin lesions and neutropenia who developed neutrophilic dermatoses precipitated by G-CSF. Whole exome sequencing performed at 36 years of age revealed a gain-of-function mutation in the WAS gene, leading to a diagnosis of X-linked neutropenia. This case report provides closure on a decades-long diagnostic odyssey and underscores the importance of genetic sequencing in patients who present with unusual dermatologic findings.     

A case of pityriasis rubra pilaris with associated focal acantholytic dyskeratosis complicated by Kaposi's varicelliform eruption

The clinical and histopathological diagnosis of pityriasis rubra pilaris (PRP) can be difficult because clinical findings are often subtle in early stages, and microscopic findings can overlap with those of other skin diseases. Focal acantholytic dyskeratosis (FAD) can rarely be seen in PRP and can mimic Darier's disease, Grover's disease or other disorders characterized by these histopathologic features. Kaposi's varicelliform eruption is a widespread infection due to herpes simplex virus (HSV) types 1 and 2, coxsackievirus A16 or vaccinia virus, occurring in a preexisting dermatosis; only one case has been reported in PRP. We report a patient with PRP whose biopsies showed both herpes simplex infection and FAD. A complete understanding of the mechanism behind this eruption evolved gradually, aided in great measure by the histopathologic findings.     

The performance of telescoping fat pad biopsies for detecting systemic amyloidosis: a four and a half year retrospective analysis and brief review of the fine needle aspiration literature

Systemic amyloidosis has historically been diagnosed by organ biopsy and Congo red staining, with reported sensitivities that exceed 90%. The abdominal fat pad fine needle aspiration (FNA), introduced in the 1970's, carries sensitivity estimates largely derived from studies with deficiencies. Patient follow‐up is often unclear and proportionally low numbers of patients are verified as true negatives. Issues in other studies include only testing verified systemic amyloidosis cases. The telescoping fat pad biopsy (TFPB) is used as an alternative to FNA and is similarly carried out quickly with low morbidity. Although the two methods would seem to be comparable intuitively, this has not been established because sensitivity data for the TFPB method is scarce to non‐existent. The charts of 58 consecutive patients who underwent TFPB screening for amyloidosis in a single hospital from August of 2010 to January 2015 were examined. All six TFPB positive patients were determined to be true positives. Eight TFPB negative patients were concurrently determined to have systemic amyloidosis by other methods – organ biopsy (7) and mass spectrometry (1) resulting in a 43% sensitivity. The remaining patients were categorized into 25 true negatives and 18 that were indeterminate based on clinical course and other biopsy results.     

Treatment of inflammatory dermatoses by tumour necrosis factor antagonists

BACKGROUND: The treatment of inflammatory skin diseases is at present often empirical as causal therapeutic approaches, based on an incomplete knowledge of the immune pathogenesis, are mostly unavailable. The currently applied treatments can in fact lead to remission of the disease; however, under certain circumstances undesirable side-effects must be expected. On the basis of experience gained in cytokine modulation therapy of chronic inflammatory diseases such as rheumatoid arthritis and psoriasis, the application of TNF-alpha inhibitors represents a novel, more specific, and effective therapeutic option for distinct chronic inflammatory diseases. PATIENTS AND METHODS: The current status of the therapeutic effect of TNF-alpha blockers is discussed based on our own observations and a review of the current literature. Also discussed are potential undesirable side-effects and possible contraindications of this therapy. RESULTS AND CONCLUSIONS: Based on recent findings, the use of TNF-alpha blockers seems to be promising in the treatment of therapy-resistant inflammatory dermatoses. At present, guidelines for indications and contraindications of anti-TNF-alpha treatment of inflammatory skin disorders are rare. Such guidelines are necessary to improve the efficacy of anticytokine treatment and the reduction of side-effects.     

Multiple apocrine poromas: a new case report

Apocrine poromas are rare and distinctive benign adnexal neoplasms featuring tumor cells differentiating toward folliculosebaceous‐apocrine units. We report an extremely rare case with multiple apocrine poromas in a single patient. Fifteen tumors were distributed on the head, neck, forearm and axilla of a 74‐year‐old man. All tumors were mostly composed of poroid cells that surrounded variably sized duct spaces, some of which exhibited decapitation secretion. The poroid cells were continuous with infundibulum‐like structures that contained aggregates of mature sebocytes. The patient had no family history of similar tumors and no history of immunosuppressive therapy. This is the first report of multiple apocrine poromas, suggesting that predisposing genetic factors might play a part in the development of the tumors.     

A case of metastatic non‐neural granular cell tumor in a 13‐year‐old girl

Conventional granular cell tumor represents a mesenchymal neoplasm observed in a variety of locations and is now believed to be of Schwann cell origin. Granular cell change has also been observed in a variety of different tumors, but recently described in the skin has been a distinct entity termed non‐neural granular cell tumor, which lacks expression of S100 protein and is of uncertain histogenesis. This tumor typically displays a greater degree of nuclear atypia and mitotic activity than conventional granular cell tumor but appears to behave in a relatively benign fashion, as only two previous instances of lymph node metastasis have been documented. Herein, we report a case of non‐neural granular cell tumor arising on the back of a 13‐year‐old girl, and later axillary lymph node metastasis with extracapsular extension was observed.