应用颏下动脉岛状皮瓣治疗颏部黑痣

目的:探讨颏下动脉皮瓣修复颏部黑痣的可行性及优越性.方法:对6例颏部黑痣患者行一次性黑痣切除,设计颏下动脉皮瓣Ⅰ期修复黑痣切除后的创面.结果:6例颏部黑痣患者术后皮瓣全部成活,患者及家属时术后外观满意,无挛缩现象发生.结论:颏下动脉皮瓣与颏部组织类似的特性,颜色质地好,供区隐蔽,手术操作相对简单,安全快速,是I期修复颏部黑痣的理想的方法.     

新型强脉冲光治疗面部雀斑疗效观察

目的：采用自身对照观察具有完美脉冲技术（optimal pulse technology,OPT）的新型强脉冲光（intense pulsed light,IPL）治疗面部雀斑的疗效。方法：选取10例雀斑受试者,随机将每人左右面部分为治疗侧和未冶疗侧,治疗侧给予新型OPT—IPL治疗,未治疗侧不予治疗。治疗后对雀斑清除情况进行评价,受试者对疗效进行满意度评价。根据治疗前、后雀斑面积和严重程度指数（Freckles area and severity index,FASI）计算雀斑改善率。结果：治疗结束后随访时,70％以上的受试者皮损清除达50％以上、80％以上的受试者对治疗满意甚至非常满意。治疗侧治疗过程中、治疗后6个月随访时,FASI波动于7．9～9．4,明显低于首次治疗前的28．4;雀斑改善率维持在66％-70％,明显高于未治疗侧。结论：新型OPT—IPL可安全、有效地治疗面部雀斑。     

景天祛斑胶囊联合超声透入氢醌霜治疗黄褐斑的临床研究

目的：观察景天祛斑胶囊联合超声透入氢醌霜治疗黄褐斑的临床疗效。方法本研究为随机对照研究。将符合纳入标准的180例黄褐斑患者采用随机数字表法分为2组,对照组80例给予超声波透入2%氢醌乳膏;治疗组100例在对照组基础上加服景天祛斑胶囊,均连续治疗2个月。评价治疗结束时和2个月后随访时症状和皮肤损伤总积分。结果治疗结束时,治疗组治愈率为81.0%(81/100),对照组为67.5%(54/80),2组比较差异有统计学意义(χ2＝4.320,P＝0.038)。2个月后随访时,治疗组治愈率为92.0%(92/100),对照组为76.3%(61/80),2组比较差异有统计学意义(χ2＝5.538,P＝0.019)。治疗组治疗结束时、2个月后随访时皮损总积分[(1.61±0.84)分、(1.30±0.85)分比(3.48±1.02)分,t＝14.152、16.419]均较治疗前降低(P＜0.01);对照组治疗结束时、2个月后随访时皮损总积分[(2.04±0.61)分、(2.03±0.51)分比(3.45±1.09)分,t＝10.097、10.554]均较治疗前降低(P＜0.01)。治疗组治疗结束、2个月后随访时皮损总积分下降程度较对照组显著(t值分别为3.839、6.767,P＜0.01)。结论景天祛斑胶囊联合超声波透入氢醌乳膏可有效治疗黄褐斑。     

白茶、玫瑰花及玳玳花提取物对体外培养黑素细胞功能的影响

[目的]观察白茶、玫瑰花及玳玳花提取物（祛斑因子A、B）对体外培养的正常人表皮黑素细胞功能及角质形成细胞和黑素细胞共培养体系中黑素小体转运的影响。[方法]制备含药血清,建立正常人表皮黑素细胞体外培养体系,采用4-甲基偶氮唑蓝（MTT）法测定黑素细胞增殖,酪氨酸酶多巴速率氧化法测定酪氨酸酶活性,NaOH裂解法测定黑素生成量,逆转录-聚合酶链反应（RT-PCR）检测黑素细胞酪氨酸酶mRNA的表达,Pull-down法检测黑素细胞GTP-RhoA和GTP-Rac1蛋白的表达;建立正常人角质形成细胞和黑素细胞的体外共培养体系,流式细胞术检测共培养细胞体系中黑素转运的情况。[结果]与空白血清对照组相比,祛斑因子A、B可显著抑制酪氨酸酶活性;祛斑因子A可显著降低酪氨酸酶mRNA的表达。祛斑因子A中、低剂量可抑制树突结构蛋白的表达。祛斑因子A高、中、低剂量及祛斑因子B均可抑制黑素小体的转运。[结论]为祛斑因子用于色素性疾病的保健防治提供一定的实验依据。     

Clinical characteristics of pigmented macules on palms and/or soles appearing after middle age in Japan

We have examined the clinical characteristics of pigmented macules on palms and/or soles. A total of 238 inpatients and 111 healthy persons over 40 years old in Japan were included in our analysis. We found: (a) that such pigmented macules may occur not only on healthy persons but also on patients who suffer from various internal disorders, (b) that, in both males and females, the incidence of pigmented macules is relatively high in malignancy patients in comparison with non-malignancy and control individuals, (c) that the incidence is higher in males than in females, (d) that, in both males and females, there was a tendency toward distribution on both palms and soles in malignancy patients in comparison with the non-malignancy and control individuals (p<0.01), and (e) that, among cases with pigmented macules, the number of pigmented macules is empirically greater in inpatients (the malignancy and non-malignancy groups) than in the controls.     

Malignant melanoma of the sympathetic chain: with a consideration of pigmented nerve sheath tumours

A case of malignant melanoma of the posterior mediastinum, arising from the sympathetic chain is reported. The structural features and the presence of long-spaced collagen on electron microscopic examination suggest schwannian derivation of the tumour. Similar tumours are reviewed and the histogenesis of pigmented nerve sheath tumours in general is discussed. The term 'malignant melanotic schwannoma' is probably the most appropriate for the tumour entity described here.     

A clinically invisible melanoma

We report a case of an amelanotic lentigo maligna incidentally found on a shave biopsy in an 87‐year‐old woman. Amelanotic lentigo maligna is a rare variant of lentigo maligna. It is often reported as presenting as erythematous scaly macules and is usually confused as benign dermatoses. Here were present a case of amelanotic lentigo maligna with no visible or palpable features.     

口腔婴儿黑色素神经外胚瘤的诊断及治疗

目的:探讨口腔婴儿黑色素神经外胚瘤的诊断要点及治疗原则.方法:对北京大学口腔医学院1980年至2007年8月间收治的13例口腔婴儿黑色素神经外胚瘤病例进行回顾性研究,复习临床资料及病理切片.结果:9例口腔婴儿黑色素神经外胚瘤发生于上颌骨,3例位于下颌骨,1例位于颊部.发病年龄从2个月至7个月.临床症状均为肿物,5例术前检查发现肿物为紫红色或蓝黑色.肿物生长迅速,3例术前诊断为恶性肿瘤,仅有1例术前临床诊断为婴儿黑色素神经外胚瘤.9例有随访结果,2例确定复发,复发时间均为术后1个月,1例死亡.1例切除不完全的病例术后19年无复发.结论:口腔婴儿黑色素神经外胚瘤具有典型的发病部位与发病年龄,临床检查时应注意肿物的颜色.肿瘤常生长迅速,具有局部侵袭性.对患者术后半年内要密切随访;病理诊断要与儿童小圆细胞恶性肿瘤相鉴别;相对保守的手术为首选治疗方式.     

Dermoscopy of pigmented lesions on mucocutaneous junction and mucous membrane

Background The dermoscopic features of pigmented lesions on the mucocutaneous junction and mucous membrane are different from those on hairy skin. Differentiation between benign lesions and malignant melanomas of these sites is often difficult. Objective To define the dermoscopic patterns of lesions on the mucocutaneous junction and mucous membrane, and assess the applicability of standard dermoscopic algorithms to these lesions. Patients and methods An unselected consecutive series of 40 lesions on the mucocutaneous junction and mucous membrane was studied. All the lesions were imaged using dermoscopy devices, analysed for dermoscopic patterns and scored with algorithms including the ABCD rule, Menzies method, 7‐point checklist, 3‐point checklist and the CASH algorithm. Results Benign pigmented lesions of the mucocutaneous junction and mucous membrane frequently presented a dotted‐globular pattern (25%), a homogeneous pattern (25%), a fish scale‐like pattern (18·8%) and a hyphal pattern (18·8%), while melanomas of these sites showed a multicomponent pattern (75%) and a homogeneous pattern (25%). The fish scale‐like pattern and hyphal pattern were considered to be variants of the ring‐like pattern. The sensitivities of the ABCD rule, Menzies method, 7‐point checklist, 3‐point checklist and CASH algorithm in diagnosing mucosal melanomas were 100%, 100%, 63%, 88% and 100%; and the specificities were 100%, 94%, 100%, 94% and 100%, respectively. Conclusion The ring‐like pattern and its variants (fish scale‐like pattern and hyphal pattern) are frequently observed as well as the dotted‐globular pattern and homogeneous pattern in mucosal melanotic macules. The algorithms for pigmented lesions on hairy skin also apply to those on the mucocutaneous junction and mucous membrane with high sensitivity and specificity.