持久性豆状角化过度症1例

患者男,59岁。双侧手、足角化性丘疹10年。皮肤科情况:双侧手、足及踝关节周围角化性丘疹,暗红色,丘疹直径1~5mm,表面干燥。皮肤组织病理:角化过度伴角化不全、表皮萎缩、基底细胞液化变性,真皮浅层致密的淋巴细胞呈带状浸润。诊断:持久性豆状角化过度症。     

肢端角化性弹力样变病

本文报告一例肢端角化性弹力样变病(acrokeratoelastoidosis,AKE)并复习文献.病例报告:8岁女孩,病史3年.损害为小的坚实的角化性丘疹,见于手足背部和手掌与手背交界部皮肤,在拇指和示指间更加明显,从这一指尖至另一指尖形成近乎连续的线状排列.有些部位丘疹融合.无主觉症状.掌蹠轻度角化,不多汗.无家族史.病理改变为表皮轻度乳头瘤样增生和中度不规则棘层肥厚,伴以明显的粒层增厚和角化过度.真     

长期服用囊虫丸致砷角化症和多发鲍温病1例

报告1例因长期服用囊虫丸所致的砷角化症和多发鲍温病。患者男,54岁。手足角化性丘疹20年,全身皮肤色素异常伴暗红色斑、破溃5年。曾因“脑囊虫病”间断服用“囊虫丸”10年。皮肤科情况掌跖部可见密集的点状角化型丘疹,其间杂以鸡眼角化型丘疹,双侧手指背、侧面起疣状角化型丘疹;全身弥漫性褐色色素沉着,其间杂以“雨滴样”色素减退斑;肩部、胸部、背部、臀部、股部等处见大小不等暗红色斑片、斑块,部分破溃。组织病理①砷角化症;②鲍温病。确诊。并对砷角化症进行简要综述。     

多发性疣状角化不良瘤一例

46岁男性患者。额部、左颞部角化性丘疹1年,缓慢增大。皮损组织病理示:表皮角化过度伴角化不全,不规则增生,棘层松解,基底层上方形成裂隙,可见谷粒及圆体。诊断:疣状角化不良瘤。肿物切除术后愈合良好,无复发。     

疣状角化不良瘤1例

患者男,66岁,面部丘疹偶伴瘙痒1年。体检:左侧眼睑下可见一黄豆大小褐色丘疹,疣状外观,中央角化略凹陷,表面粗糙,无明显渗出。皮损组织病理示:表皮内见两处杯状凹陷,内充满大量角化物,伴角化不全,基底层可见棘层松解性裂隙及绒毛结构,细胞分化良好。诊断:疣状角化不良瘤。治疗:手术切除。随访2个月无复发。     

恶性黑棘皮病并发Leser-Trélat征1例

患者男,72岁。全身褶皱部、乳晕肥厚、色素沉着3个月,周身泛发性丘疹伴剧痒2个月。皮肤科情况:颈部、腋窝、腹股沟、肛周皮肤肥厚、色素沉着,呈绒毛状或乳头瘤样增生,双侧乳头和乳晕角化、色素沉着,颈部、躯干及四肢散在米粒至黄豆大肤色至淡褐色角化性丘疹及斑丘疹。皮损组织病理示(上胸部):表皮角化过度,棘层肥厚,乳头瘤样增生,基底层色素增加;(右侧腹股沟):表皮中度角化过度,乳头瘤样增生,乳头似指样向上凸出,棘层中度肥厚,基底层色素增加,真皮浅层少许淋巴细胞浸润。诊断:恶性黑棘皮病并发Leser-Trélat征。     

靶样丘疹型血管角化瘤

患者男,21岁,右肩胛区黑紫色丘疹3年,加重伴不适2个月.皮损组织病理学检查:表皮角化过度,角化不全,棘层肥厚,真皮浅层毛细血管扩张,管腔内充满大量红细胞,部分扩张的毛细血管被延伸的表皮突包绕,血管周围炎性细胞浸润,真皮可见较多红细胞外渗.诊断:靶样丘疹型血管角化瘤.     

炎性线状疣状表皮痣3例

例1男,36岁,右足小趾、足背外缘沿小腿屈侧至腘窝出现暗红色角化性丘疹、斑块伴瘙痒32年.例2女,4岁,左下腹及腹股沟红色或红褐色丘疹、斑丘疹沿Blaschko线分布至外阴部,伴瘙痒3年半.例3男,26岁,右手背、手指、上肢至肩部暗红色丘疹、斑丘疹伴瘙痒3年.该3例皮损组织病理均示:表皮角化过度伴角化不全,棘层肥厚,呈...     

Cowden综合征1例

患者女,19岁,口腔、面、四肢丘疹15年,腹痛2周。皮肤科情况:口腔黏膜、舌部、面部及四肢可见散在皮色角化性丘疹,部分呈疣状或乳头瘤样,面部为甚。胃肠镜检查:消化道多发性息肉。组织病理学检查:(胃窦黏膜)增生性息肉伴中度慢性炎症,HP(+);(舌部)鳞状上皮乳头状瘤;(右前臂)表皮角化过度,局部棘层及颗粒层增生。诊断:Cowden综合征。     

VPW532nm激光治疗血管角化瘤24例

血管角化瘤（Angiokeratoma）分5型,即①肢端血管角化瘤;②阴囊血管角化瘤;③丘疹型血管角化瘤;④局限性血管角化瘤;⑤泛发性系统型一弥漫性躯体血管角化瘤。2003年5月至2008年4月我们应用可调脉宽倍频532nm激光（美国科医人公司）治疗肢端型血管角化瘤24例,取得了满意疗效,现报道如下。     

Ageing and photoageing of keratinocytes and melanocytes

An overview of keratinocyte and melanocyte function is provided. The processes of cutaneous ageing and photoageing are defined, and age-associated modulations in gene expression are described. The changes in keratinocytes and melanocytes that occur with skin ageing and photoageing and the characteristics of chronologically aged vs. photoaged skin are delineated. Mutations that are found in malignant and premalignant tumors of epidermal origin are described.     

中外白癜风诊疗指南及共识比较

本文从白癜风分型、分期、病情评估、药物治疗及非药物治疗等方面比较了欧洲、美国、日本、韩国、中国等地区和国家的白癜风诊疗指南或共识, 概要分析各指南及共识中推荐的白癜风疗法和强调理念的异同, 以帮助临床医生为白癜风患者提供合适的个体化治疗方案。     

The prognosis and treatment of angiosarcoma of the face and scalp

Angiosarcoma of the face and scalp (AS) is a rare but well-recognized vascular tumour, generally accepted to have a very poor prognosis. However, most previous studies have been limited because of small patient numbers.
We have collected clinical data on 71 patients with AS from the time of initial histological diagnosis. Information obtained included age at diagnosis, sex, race, clinical appearance and size of lesions, therapeutic procedures, clinical course, incidence of metastases, survival time and response to therapy.
All the patients were Caucasian with a mean age of 74 years (range 56–72 years) and a male to female ratio of 1:5:1. Tumours occurred predominantly on the upper face and scalp but male patients frequently presented with central facial lesions. Three main clinical patterns were confirmed: nodules, bruise-like induration and areas of ulceration with bleeding.
Most patients were treated by radiotherapy (64%) or by excision alone (10%). The remainder received no therapy or combined therapy. Radiotherapy-treated patients fell into two groups: group I (71%) had short survival times ( x= 13.5 months), large lesions (63% < 10 cm), and a high incidence of metastatic disease (50% of patients); group 2 patients (29%) survived longer ( x = 5.5 years) and had a low proportion of large tumours (8%) with a low incidence of metastatic disease (8%). Patients treated by excision alone had a high incidence (86%) of metastatic disease.
Our data suggests that AS remains a disease of poor prognosis in elderly patients with large lesions. However, small (< 5 cm) lesions have a far better prognosis and the use of radiotherapy may be associated with prolonged survival and a lower incidence of metastases than simple excision.     

两种氯雷他定药物治疗湿疹、皮炎的成本效果分析

目的：对两种氯雷他定(百为坦和开瑞坦)治疗湿疹、皮炎的成本效果进行分析．方法：将患者分为两组，每组30例，分别服用百为坦和开瑞坦，除观察疗效外还进行成本效果分析。结果：两组疗效相当，均无明显的不良反应。但百为坦的治疗成本明显低于开瑞坦．结论：氯雷他定治疗湿疹、皮炎疗效高，安全性好。百为坦比开瑞坦治疗成本低。     

光损伤性皮肤病规范化防治体系的构建及应用

目的构建光损伤性皮肤病规范化防治体系,提高疾病治愈率,减少复发率。方法基于疾病信息管理软件平台,开设专病门诊,建立信息化患者管理档案,分析疾病发生发展规律,制定个性化治疗方案,长期追踪病人,评估疗效和进行健康教育。结果自2004年至2014年,建立患者档案24800例。明确了皮肤癌、多形性日光疹、痤疮和黄褐斑的危险因素。证实光损伤性皮肤病均存在皮肤屏障受损,使用皮肤屏障修复剂是首要治疗措施。制定了日光性角化病、多形性日光疹、痤疮及黄褐斑的规范化诊疗指南。疾病治疗总有效率从73.3%增至93.3%,复发率从76.7%降至30.0%。结论应用规范化防治体系能节省医疗支出、提高人民群众身心健康水平,是今后新医疗模型的发展方向。