外伤诱发头皮基底细胞癌1例及皮肤镜表现

患者男,62岁,头枕部皮疹20余年,伴轻度瘙痒2个月余。头皮部皮损于外伤后形成,表现为局部黑色丘疹,皮肤镜检查考虑基底细胞癌,皮损组织病理检查证实为基底细胞癌。     

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.     

儿童甲下外生性骨疣特殊皮肤镜表现1例

患儿男,9岁,6个月前左足无明显诱因突发第3足趾远端疼痛性结节,皮肤镜表现为典型的树枝状血管扩张及角化过度。X线正侧位片示：左足第3足趾远端趾骨骨质增生,可见骨性肿物。皮损组织病理示：表皮可见角化过度,角化不全,真皮见骨小梁形成,散在淋巴细胞、组织细胞浸润。诊断：甲下外生性骨疣。予以手术切除后,趾甲形态正常,无复发及术后并发症。     

窄谱UVB治疗白癜风疗效及黑素恢复观察

近年来人们报道用窄谱UVB治疗白癜风有明显疗效,成为临床治疗白癜风的方法之一[1].然而,不同文献显示窄谱UVB对白癜风的临床疗效不尽相同,推测与多种影响因素有关[2].     

男同性恋者HIV感染并发其他性病3例

由于多性伴、无保护性肛交等高危性行为的普遍存在[1],男同性性接触者性传播疾病发生率较普通人群高.以往对于高危人群患多种性传播疾病的报道较多,但男同性性接触者感染HIV且并发梅毒或尖锐湿疣的报道较少,现将笔者收治的3例报告如下.     

S100蛋白阳性的多发性青少年黄色肉芽肿1例

患者男, 17岁, 因面部、眼睑丘疹伴痒痛4年, 泛发全身1年就诊。4年前无明显诱因面部出现米粒至黄豆大小圆形及类圆形淡黄色、肉色丘疹, 以眼睑最为明显, 未诊治。除眼睑部位丘疹遮挡影响视物外, 无其他不适。既往史:5年前曾出现全身丘疹、结节伴瘙痒, 当地医院诊断"疥疮", 予"硫软膏"局部外用后丘疹、结节消退, 瘙痒消失。父母兄弟均体健, 否认遗传病及家族中类似疾病。体检:一般情况良好, 各系统检查未发现异常, 全身浅表淋巴结未扪及肿大。皮肤科检查:面部及双侧上下眼睑见多发性直径0.1 ～ 0.8 cm肉色丘疹;眼睑处较大的丘疹顶端破溃结痂, 未见渗出, 双眼球右侧巩膜均可见肉色斑块附着(图1), 颈部及背部、四肢近端见大量类圆形淡红色圆顶丘疹, 腋窝较明显。实验室检查:梅毒螺旋体明胶颗粒凝集试验、快速血浆反应素环状卡片试验、人类免疫缺陷病毒、丙型肝炎病毒检查无异常;甘油三酯0.70 mmol/L(参考值< 1.7 mmol/L, 下同), 总胆固醇3.27 mmol/L(0 ～ 5.18 mmol/L)。皮损皮肤镜下见淡黄色均质状结构, 边缘可见边界不清淡红斑及少量线状血管,...     

隆突性皮肤纤维肉瘤误诊一例

报告隆突性皮肤纤维肉瘤1例,因左上臂近端无痛性肿块5年就诊,曾误诊为纤维瘤或脂肪瘤,术后被病理检查证实为隆突性皮肤纤维肉瘤。     

皮下脂膜炎样T细胞淋巴瘤一例

患者女,39岁.全身反复红斑、结节8个月,伴破溃、发热2个月.8个月前不明原因于左小腿胫前出现红斑及皮下结节,皮损逐渐增大,约5个月后全身多处分批出现相同皮损.2个月前全身各处皮损破溃,并发热,发热以夜间明显,体温波动于38℃～39℃之间,自觉乏力.经当地医院诊断为脂膜炎,给予"青霉素,头孢菌素"等抗炎治疗无效后就诊于我院.     

耐甲氧西林金黄色葡萄球菌感染引起蜂窝织炎并败血症一例

患者女．61岁,因颈前皮疹伴瘙痒7天,加重1天就诊。患者7天前外出劳作时颈前被昆虫叮咬后起一米粒大小红色丘疹．伴瘙痒。患者自行用针挑破后,患处出现红肿,此后起群集性绿豆大小水疱、血疱,伴疼痛。皮疹逐渐蔓延至前胸,同时伴胸闷、心悸、纳差。遂来我院就诊。来院前未经诊治。患者既往体健。[第一段]