Myoepitheliale Tumoren der Haut und des Weichgewebes

Zusammenfassung Myoepitheliale Tumoren der Haut und des Weichgewebes umfassen kutane Mischtumoren (chondroide Syringome), Mischtumoren der Subkutis und des tiefen Weichgewebes, Myoepitheliome und die seltenen malignen Myoepitheliome (myoepitheliale Karzinome). Wie auch in anderen anatomischen Lokalisationen sind Myoepitheliome der Haut und des Weichgewebes durch eine außerordentliche klinisch-pathologische Heterogenität charakterisiert. Die Tumoren entstehen sowohl im Kindes- als auch im Erwachsenenalter und bestehen aus epithelioiden, histiozytoiden, spindeligen, plasmozytoiden und/oder klarzelligen Tumorzellen in wechselnder Zusammensetzung, die in einer myxoiden oder hyalinisierten Matrix angeordnet sind. Immunhistochemisch nachweisbar werden von den Tumoren epitheliale Marker (Panzytokeratin und/oder epitheliales Membranantigen), häufig S-100 Protein sowie teilweise muskuläres Aktin, gliales saures Faserprotein, Calponin und p63 exprimiert, während Desmin in der Regel nicht zu detektieren ist. Der Nachweis mittel- bis hochgradiger zytologischer Atypien ist in Myoepitheliomen mit einer verschlechterten Prognose assoziiert, und maligne Myoepitheliome können in einer signifikanten Anzahl von Fällen metastasieren und zum Tode der betroffenen Patienten führen.     

局灶性真皮发育不全一例

患者男,17岁,出生时即出现多发条纹状红色斑片和丘疹,红色斑片菲薄易破,愈后遗留色素减退斑片。右手第1、2指指甲发育不全。随年龄增长逐渐出现泛发线状或漩涡状色素沉着条纹,部分黄红色丘疹增大形成斑块。于儿童期始逐渐出现多发的乳头瘤样皮损,以口周为著。皮肤科检查：全身泛发线状或漩涡状的色素沉着斑片,以躯干为著,其间散在色素减退斑片与黄红色斑块。口周、下颌及右胭窝多发乳头瘤样皮损。皮损组织病理检查：表皮角化不全,真皮厚度显著变薄,真皮乳头层血管增多,皮下脂肪层上移。诊断：局灶性真皮发育不全。     

A型肉毒毒素注射治疗眉间纹的高频超声研究

【摘要】 目的 研究A型肉毒毒素治疗眉间纹引起的皮肤及其下肌层的厚度改变。方法 收集北京协和医院2017年8月至2018年2月注射A型肉毒毒素治疗的26例中重度眉间纹受试者,于注射前及注射后4周、16周,采用50 MHz高频超声检测注射部位皮肤的真皮层厚度,20 MHz高频超声检测皮肤全层和肌层厚度。采用单组重复测量资料的方差分析、配对t检验及Bonferroni法比较受试者注射治疗前后3个时间点超声检测的组织厚度。结果 注射前,真皮层、皮肤全层和肌层厚度分别为（2.01 ± 0.48）、（4.32 ± 0.73）、（4.51 ± 0.67） mm。注射前、注射后4及16周真皮层厚度差异无统计学意义（F = 1.94,P = 0.199）,而皮肤全层厚度、肌层厚度差异均有统计学意义（F = 6.28、24.19,P = 0.020、 < 0.001）。与注射前相比,注射后4周皮肤全层厚度显著增加（4.88 ± 0.93 mm,t = 3.72,P = 0.004）,而肌层厚度显著降低（3.82 ± 0.79 mm,t = 4.65,P = 0.001）。与注射前和注射后4周相比,注射后16周时皮肤全层厚度（4.61 ± 0.73 mm）和肌层厚度（4.38 ± 0.90 mm）差异均无统计学意义（均P > 0.0167）。结论 注射A型肉毒毒素可改变皮下组织和肌层厚度,高频超声可用于A型肉毒毒素注射治疗眉间纹的疗效评价及随访。     

Pseudoxanthoma elasticum-like papillary dermal elastolysis in non-exposed skin

Pseudoxanthoma elasticum-like papillary dermal elastolysis is an acquired elastic tissue disorder clinically similar to pseudoxanthoma elasticum in the absence of systemic involvement. Histopathologically, special staining of elastic fibers demonstrates a total or partial band-like loss of elastic fibers in the papillary dermis. Although ultraviolet radiation seems to be one of the main etiological factors in this entity, we report a case of pseudoxanthoma elasticum-like papillary dermal elastolysis on the neck of a woman who wore hijab.     

角质形成细胞与黑素细胞体外构建含黑素的组织工程皮肤

目的 探讨体外构建含黑素的组织工程皮肤.方法 采用两步酶消化法处理健康小儿包皮,获得表皮细胞悬液,分别用人角质形成细胞(KC)无血清培养基(SFM)及改良的M254黑素细胞培养基培养KC、黑素细胞(MC),并传至第3代.将第3代KC接种于培养瓶中,48 h后加入第3代MC(MC:KC为1:10)混合培养.制备人去表皮的真皮(DED),将培养第3代的MC、KC制成细胞悬液,按照1:10的比例接种于DED表面,采用液下培养和空气-液面培养相结合的方式进行培养,2周后取培养的组织工程皮肤分别做HE染色、角蛋白免疫组化染色及Masson-Fontana染色.结果 KC、MC混合培养于培养皿5 d后,于倒置显微镜下观察到KC呈铺路石状生长,其间散布MC,且树突延伸到KC细胞间.两种细胞混合接种于DED 15 d后,HE染色显示在DED上有3～6层表皮细胞,并可见角质层,角蛋白免疫组化染色阳性,银氨染色显示基底层见黑素着色.结论 MC、KC混合接种于培养皿可构建MC和KC接触生长的单细胞层,将MC、KC接种于DED可构建含有黑素成分的组织工程皮肤.

Abstract：

Objective To construct tissue-engineered skin containing melanin with mixed culture of human keratinocytes (KCs) and melanocytes (MCs) on de-epidermized dermis (DED) in vitro. Methods Single-cell suspension was obtained by digestion of isolated preputial epidermis with pancreatin. Keratinocyte serum-free medium (K-SFM) and modified M254 culture medium were used to culture KCs and MCs respectively. Third-passage KCs were seeded into cell culture flasks and cultured for 48 hours; then, third-passage MCs were seeded into the same cell culture flasks with the MC/KC ratio being 1: 10 followed by a 5-day coculture. The suspension of third-passage KCs and MCs with the MC/KC ratio of 10:1 were seeded onto the surface of a prepared DED and maintained at the air-liquid interface for 11 days following a 4-day submerged culture.Subsequently, the constructed tissue-engineered skin was examined with HE staining, immunohistochemical staining for keratin and Masson-Fontana staining. Results After coculture in flasks for 5 days, KCs exhibited a typical paving-stone appearance, MCs with projected dendrites were scattered in the extracellular space between KCs. HE staining revealed 3 to 6 layers of cells with the formation of stratum corneum after mixed culture on DED for 15 days. Keratin protein was positive throughout the artificial epidermis, and melanin pigments were located in the basal layer of the epidermis as Masson-Fontana staining showed. Conclusions The co-culture of MCs and KCs can form single-cell layers with the contact between MCs and KCs in flasks, and construct tissue-engineered skin with melanin component on DED in vitro.     

Our initial learning curve in the enzymatic debridement of severely burned hands—Management and pit falls of initial treatments and our development of a post debridement wound treatment algorithm

Introduction

Excisional surgical debridement (SD) is still the gold standard in the treatment of deeply burned hands, though the intricate anatomy is easily damaged. Previous studies demonstrated that enzymatic debridement with the bromelain debriding agent NexoBrid^® (EDNX) is more selective and thus can preserve viable tissue with excellent outcome results. So far no method paper has been published presenting different treatment algorithms in this new field. Therefore our aim was to close this gap by presenting our detailed learning curve in EDNX of deeply burned hands.

应用组织工程化皮肤修复皮肤全层缺损

目的本研究旨在评价组织工程技术修复皮肤缺损的可行性。方法采用Ｙｏｒｋｓｈｉｒｅ猪,在其背部脊柱两侧做６个直径４ｃｍ的圆形全厚皮肤缺损,随机分为３组。第１组为空白对照,第２组仅置无细胞的ｐｌｕｒｏｎｉｃ;第３组分别用角朊细胞－ｐｌｕｒｏｎｉｃ、成纤维细胞－ｐｌｕｒｏｎｉｃ复合物置于创面上。第４、６周时取材,进行大体,组织学和透射电镜观察。结果４－６周时表皮和真皮间界面明显被上皮嵴和真皮乳头所分隔。对     

Outdoor post-mortem bite injuries by Tapinoma nigerrimum (Hymenoptera,Formicidae) on a human corpse: Case report

Ants are among the insects that colonize exposed human and animal corpses during the early stage of decomposition. In Calabria, Italy (as well as in other countries), Formicidae have been observed preying on immature stages of Diptera and other insects, as well as causing irregular scalloped areas of superficial skin loss on human corpses and animal carcasses. We present a case of injuries on a human corpse caused by ant feeding. The macroscopic appearance is described and the results of a histochemical investigation of the skin lesions caused by worker ants are reported for the first time. The investigation was carried out on the fresh corpse of a 53-year-old man discovered in a rural area of Cosenza province (Calabria, southern Italy). Numerous irregular areas of superficial skin loss caused by the ant Tapinoma nigerrimum (Nylander 1856) (Hymenoptera, Formicidae) were observed on the body surface, inflicted very early in the post-mortem period. Because the classification of lesions is of crucial importance for forensic investigations, the macroscopic appearance and distribution pattern of the lesions on the corpse are illustrated. The histochemical investigation of the damaged skin explains, for the first time, the mechanism of production of the lesions.     

Analysis of cell characterization using cell surface markers in the dermis

Background

In recent years, it has been reported that stem cells exist in the mesenchymal tissues of the bone marrow and adipose. These stem cells are thought to express specific cell surface markers such as CD44, CD54, CD105, CD90, and CD271 and have been confirmed to be pluripotent. Furthermore, although it has been reported that stem cells are also present in the dermis, their cell surface markers and characteristics are not fully understood.

Objective

To confirm the presence of stem cells in the dermis and their ability, employing the mesenchymal stem cell markers which have previously been reported as an indication.

Methods

We analyzed the percentages of CD44 (+), CD54 (+), CD90 (+), CD105 (+), and CD271 (+) cells in the dermis of neonatal mice (HR-1 mouse) by performing immunostaining and FACS. Secondly, we isolated each type of marker-positive and -negative cells from dermal tissues and evaluated their proliferation potential and their ability to differentiate into adipocytes, osteoblasts, and chondrocytes.

Results

According to the immunostaining and FACS results, we confirmed that stem cells that express CD44, CD54, CD90, CD105, and CD271 are present in the dermal tissues of neonatal mice. In addition, when we measured the proliferation and differentiation potentials of each type of marker-positive cells, it was revealed that cells expressing CD54 or CD271 have a high proliferation potential and are able to differentiate into adipocytes, osteoblasts, and chondrocytes.

Conclusions

These results indicated that dermal tissues contain stem cells that express CD44, CD54, CD90, CD105, and CD271 which are stem cell markers. More precisely, it was suggested that both CD54 (+) and CD271 (+) stem cells have high proliferation and differentiation potentials.