以皮肤病为首发表现的胃癌2例报道并文献复习

目的提高临床医生对伴发皮肤病的恶性肿瘤的警惕和认识,减少漏诊。方法对笔者所在医院近两年诊治的2例分别以红皮病和皮肌炎为首发表现的胃癌患者的临床资料并结合相关文献进行分析。结果2例患者均因皮肤病人院,行胃镜检查诊断为胃癌,行手术切除,术后病理学检查证实为胃癌伴发皮肤病。结论伴肿瘤性皮肤病可以看做是内脏恶性肿瘤的早期表现,该类患者需要通过肿瘤标志物、胃镜、PET／CT等检查以排除内脏肿瘤。     

复方甘草酸苷联合阿维A治疗红皮病型银屑病的疗效观察

目的观察阿维A胶囊与复方甘草酸苷胶囊联合治疗红皮病型银屑病的临床疗效。方法62例患者随机均分为两组,治疗组采用复方甘草酸苷联合阿维A治疗;对照组仅单用阿维A治疗。治疗8周后观察疗效。结果治疗组有效率（93．55％）明显高于对照组（80．65％）,差异有统计学意SL（P〈0．05）。结论阿维A胶囊联合复方甘草酸苷胶囊治疗红皮病型银屑病安全、有效,并可减少药物副作用。     

Leukemic erythroderma with elevated plasma IL-3 and hyperhistaminemia: in situ expression of IL-3 mRNA in leukemic cells

We report a case of chronic myelogenous leukemia (CML) with pruritic erythroderma. Hyperhistaminemia, elevated level of plasma interleukin-3 (IL-3), and moderate basophilia were noted in this case. His skin manifestation was resistant to topical corticosteroid therapy and exacerbated in parallel with leukocyte count, plasma histamine and IL-3 levels. To identify localization and production of IL-3 in our case, we performed in situ hybridization on peripheral blood cells and skin biopsy specimen, and detected IL-3 mRNA in myelogenic cells in both specimens.     

阿帕替尼与特瑞普利单抗联用致红皮病

1例66岁男性恶性黑色素瘤患者接受阿帕替尼(250 mg口服、1次/d)、替莫唑胺(口服,第1天500 mg,第2~4天400 mg/d)和特瑞普利单抗(240 mg静脉滴注、第1和第15天)联合治疗。5个周期(28 d为1个周期)后出现多发皮疹,可见头面部、躯干、四肢皮损,伴红疹、脱屑;全身水肿,四肢肿胀,双下肢为重,伴黏液渗出。第6个周期将阿帕替尼减量(250 mg口服、1次/3 d),皮疹未减轻。实验室检查示血清白蛋白28.5 g/L,血清总蛋白55.5 g/L,嗜酸粒细胞0.096,血钾3.17 mmol/L。考虑为阿帕替尼和特瑞普利单抗联用所致红皮病,停用2药,给予甲泼尼龙、氯雷他定、苯海拉明、曲安奈德益康唑乳膏(外用)、莫匹罗星软膏(外用)及皮肤护理,同时予补充蛋白、利尿、补钾、护胃等对症治疗。治疗10 d后皮疹消退,脱屑、瘙痒减轻。     

Actinic reticuloid simulating sézary syndrome

Summary A report is given on two male patients who showed all the main characteristics of Sézary syndrome (SS). When phototested, however, they proved to be extremely photosensitive, which suggested a diagnosis of actinic reticuloid (AR). This was supported by the predominance in blood and skin specimens of lymphoid cells with a suppressor/cytotoxic phenotype, the absence of clonal cell proliferation and a benign clinical course. Differential diagnostic problems of SS and erythrodermic AR are discussed.     

狒狒综合征并发红皮病1例

患者女,47岁。颈部、双侧腋窝、腰骶部及双股红斑肿胀7天,加重伴发热4天。患者接触汞后,上述部位出现红斑,并出现红皮病样表现。血清转氨酶水平升高,蛋白水平降低。尿汞水平正常。经对症治疗1周后,红斑消退,血清转氨酶水平下降。     

红皮病患者低钾血症预后的影响因素分析

<正>机体的血钾参与并维持细胞代谢,保持细胞内液渗透压及酸碱平衡,并可维持神经肌肉组织兴奋及心肌功能~([1-2])。中重度低血钾主要表现为肌无力,可延及机体的躯干和呼吸肌,造成呼吸困难,还可引发腱反射减弱或消失、肠麻痹及心脏传导阻滞、节律异