比较亮脯利特与醋酸甲孕酮注射剂皮下注射治疗子宫内膜异位症相关疼痛

目的：与亮脯利特比较，醋酸甲孕酮皮下注射（DMPA-SC104）治疗子宫内膜异位症的有效性和安全性。设计：3期多中心、随机、评价者盲法、对照比较试验。机构：加拿大和美国的临床试验点。患者：274例手术诊断的子宫内膜异位症妇女。干预：每3个月肌注DMPA-SC（104mg）或亮脯利特（11．25mg），共6个月。治疗后随访12个月。主要观察指标：5种子宫内膜异位症症状或体征的减轻（痛经、性交困难、盆腔痛、盆腔触痛、盆腔硬化）；骨密度（BMD）改变、低雌激素的症状、出血及体重的变化。结果：DMPA-SC104，在治疗末（6个月）减轻5种子宫内膜异位症症状或体征的4种，在12个月随访末（18个月）减轻全部5种症状，与亮脯利特统计学上效果相当。DMPA-SC104组患者显示在6个月较亮脯利特有更少的BMD损失，在随访的12个月又回到基线水平。

Subcutaneous injection of depot medroxyprogesterone acetate compared with leuprolide acetate in the treatment of endometriosis-associated pain

Aleukaemic leukaemia cutis is a rare condition characterized by infiltration of leukaemic cells into the skin before they appear in the peripheral blood. We report a case of an aleukaemic leukaemia cutis, which had a history of exposure to atomic bomb radiation. A 57-year-old Japanese woman initially presented with a 20-week history of multiple red papules and plaques mainly over the trunk. Histological examination revealed the infiltration of atypical monocytic cells in the dermis, but no leukaemic cells were detected in the peripheral blood. Twentythree weeks after the appearance of the eruption, leukaemic cells were detected in the peripheral blood for the first time. The results of immunohistochemistry of the skin biopsy specimen and flow cytometry of the peripheral blood indicated the rare phenotype of myeloid/NK cell precursor acute leukaemia. This is the first case report of myeloid/NK cell precursor acute leukaemia presenting as aleukaemic leukaemia cutis in the English literature, and awareness of this clinical presentation may be important to reach the correct diagnosis.