皮下脂膜炎样T细胞淋巴瘤10例临床分析

本研究探讨皮下脂膜炎样T细胞淋巴瘤(SPTCL)的临床、病理特征及预后。回顾性分析了经病理证实的10例SPTCL患者的临床特点、病理形态及免疫组化标记、治疗和生存情况。结果显示:临床上首发症状均表现为单发或多发皮下结节,其中8例出现持续高热、消瘦、肝功能严重受损、累及骨髓,病程进展迅速;在病理方面皮下脂肪组织内有原发的小、中或大的多形性T细胞,围绕脂肪细胞呈花环状外观;周围区组织细胞反应性增生活跃,伴有吞噬红细胞现象,并见多核巨细胞和肉芽肿样反应;瘤细胞浸润在脂肪小叶内,脂肪小叶间隔无累及;肿瘤表达细胞毒T细胞的免疫表型;10例均用CHOP为主的方案化疗,总有效率60%,3年生存率为10%,全组中位生存时间10个月。结论:本病是一种以累及皮下脂肪组织为主的侵袭性淋巴瘤,且进展快,中位生存期短,伴嗜血细胞综合症者预后差,异基因造血干细胞移植为有效的治疗手段。     

肌肉注射黄体酮致局部不良反应相关因素分析

目的：分析肌肉注射黄体酮所致局部不良反应的相关因素,明确不良反应的发生原因。方法：回顾性分析2007年5月-2008年7月在我院行IVF-ET术后肌肉注射黄体酮的152例患者的临床资料,对所得数据采用SPSS13．0统计软件包进行统计学分析。结果：将152例患者分为两组,A组78例应用黄体酮每次6支（10mg·mL^-1）,出现注射反应19例。人工性脂膜炎9例;而B组74例应用黄体酮每次3支（20mg·mL^-1）,仅1例出现注射反应,无人工性脂膜炎。结论：肌肉注射黄体酮发生不良反应可能与黄体酮溶媒量或溶媒质量相关。可采用局部治疗。     

Post‐erysipela panniculitis ossificans of the lower leg treated with pentoxifylline

We report the case of a female patient who developed a firm, wooden‐like, nonpitting edema of the left lower leg after a dermo‐hypodermitis. The clinical picture was accompanied by intense pain, strongly impacting the patient's quality of life. A soft‐tissue ultrasound demonstrated several millimetric hyperechoic linear lesions whose histopathological examination was conclusive for panniculitis ossificans. A conservative medical management with compression stockings associated with pentoxifylline 800 mg/day was prescribed with improvement of the edema and, in particular, a good pain control. To date, after a 2‐year therapy with pentoxifylline, the leg wooden‐like edema has substantially improved, despite the persistence of the well‐known foci of ossification, and the pain has resolved, conditioning a substantial improvement of the patient's quality of life. No side effect has been observed during the routine follow up. Although there is no unanimous opinion in the literature about the effect of pentoxifylline on bone formation and osteogenic differentiation, pentoxifylline treatment proved to be beneficial in our patient both for the heterotopic ossification process and the pain control. We collected some of the data in literature about pentoxifylline effects and advanced some hypotheses to explain our results. Finally, we suggest that an anti‐inflammatory and vasodilators drug such as pentoxifylline could be a possible alternative in heterotopic ossification disorders.     

Distinctive lupus panniculitis of scalp with linear alopecia along Blaschko's lines: a review of the literature

Lupus panniculitis of the scalp (LPS) is a rare and distinctive clinical feature of lupus erythematosus panniculitis (LEP) with linear alopecia along Blaschko's lines. In this study, we investigated clinical features and treatments of LPS by literature review of articles in the English language from PubMed and SCOPUS databases up to April 2018. The following key words, “lupus panniculitis, “lupus erythematosus panniculitis”, “lupus profundus”, “head”, and “scalp”, were used. Twenty cases of LPS were identified (mean age = 26.4 [10–53] years, female: male ratio = 1:1, mean disease duration = 86.89 [8–336] weeks). The most commonly affected areas of scalp included parietal (70%), frontal (45%), temporal (40%), occipital (30%), and vertex (10%), along 70% of Blaschko's lines with morphologic lesions linear, annular, arch-shaped, and ulcer. Besides, ANA (60%) was in particular noted. Hydroxychloroquine, oral prednisolone, intralesional corticosteroid, and methotrexate were the most common treatments, with complete response after an average period of 8.08 (2–12) weeks. Systemic lupus erythematosus (SLE) was developed in four cases (20%) during follow-up, with high recurrence of 35%. We reported distinctive and rare cases of LPS.The continuing follow-up was highly recommended to avoid probable recurrence and SLE development.     

Eosinophilic fasciitis as a paraneoplastic phenomenon associated with metastatic colorectal carcinoma

A 72-year-old man presented with erythema and induration of his calves and forearms. He had a past history of stage 1 colorectal carcinoma, treated with resection and primary anastamosis 4 years earlier. A diagnosis of eosinophilic fasciitis was made based on the characteristic clinical appearance, peripheral blood eosinophilia and a skin biopsy. There was no improvement in the condition following treatment with prednisolone or methotrexate. One year later, abnormal liver function studies were noted, and an abdominal computed tomography scan and subsequent needle biopsy of the liver confirmed a neoplastic lesion in the liver consistent with a metastatic colorectal carcinoma. Systemic chemotherapy with oxaliplatin, 5-fluorouracil and capecitabine was commenced, and resulted in partial remission of the colorectal carcinoma. Simultaneously, the indurations of the forearms and calves also improved, suggesting that the eosinophilic fasciitis was a paraneoplastic phenomenon.     

原发性胆汁性肝硬化/原发性硬化性胆管炎重叠综合征合并狼疮性脂膜炎1例报告

正1病例资料患者女性,51岁,因"发现肝功能异常7年,乏力1年"于2015年8月11日入院。患者主要不适为乏力,无皮肤瘙痒、高脂血症及脂肪瘤等表现。既往1994年因"口腔溃疡、面部及双上肢散在皮下结节"于吉林大学第一医院诊断为"红斑狼疮",并予皮质醇激素治疗(具体剂量及时间不详),症状缓解。     

A case of mesotherapy-induced panniculitis

Mesotherapy was first introduced in Europe for the treatment of localized pain. It is currently used mainly for aesthetical purposes and gradually getting widely used for body contouring, cellulite reduction, and skin rejuvenation. The reports concerning about mesotherapy is increasing in number in the literature. There are reported systemic and local side effects of mesotherapy. Panniculitis is a rare side effect of mesotherapy. In this article, we report a case of mesotherapy-induced panniculitis who responded to dapsone therapy.     

Subcutaneous fat necrosis of the newborn following hypothermia and complicated by pain and hypercalcaemia

A female infant was delivered at term with complications of severe meconium aspiration and birth asphyxia. Surface cooling was performed in the first 24 hours as part of the management of her birth asphyxia. Woody erythema was noted at 24 hours, followed by the formation of red-purple nodules on the 6th day. Clinical findings in the first 24 hours were suggestive of cold panniculitis. However, clinical and histological findings progressed to be in keeping with the diagnosis of subcutaneous fat necrosis of the newborn (SCFN). Furthermore, the immediate postnatal period was complicated by pain resistant to treatment with opiates. Asymptomatic hypercalcaemia was noted on periodic testing at 7 weeks and treated by rehydration, diuretics, prednisolone, etidronate and a low-calcium and -vitamin D diet. A review of the clinical and histological findings of the relevant panniculitides occurring in the postnatal period is presented, as well as a review of the treatment of hypercalcaemia in SCFN.