肢端血管角化瘤伴手足多汗症1例

报告1例肢端血管角化瘤伴手足多汗症。患者因手指背暗红丘疹伴多汗6年就诊,有明确冻伤史,手指背侧分布暗红角化丘疹,手、足多汗如洗,皮疹处病理回报表皮角化过度,棘层不规则增厚,乳头瘤样增生,真皮浅层毛细血管扩张。     

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。     

Sterilization and care of surgical instruments and supplies

Adequate instrument handling and sterilization are important aspects of office surgery. Heat sterilization is the most reliable choice. The steam autoclave is highly recommended. Dry heat is effective but can pose some storage problems. Gas sterilization is useful for heat-sensitive materials but not practical for the private office. Cold "sterilization" is not reliable for incisional surgery. In addition to proper sterilization modality selection, the surgeon must observe important standards of instrument care, packing, and storage.     

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。     

Structure and function of ethnic skin and hair

Differences have been found among blacks, whites, Asians, and Hispanics in various areas of skin structure and function. Among them is the stratum corneum lipid (ceramide) content, which is highest in Asians, then Hispanics, then whites, and lowest in blacks. Melanosomal packaging and percutaneous absorption rates for specific compounds also vary among the different races. Reports supporting the occurrence of difference in TEWL, tyrosinase levels, skin elasticity, and water absorption rates between blacks and whites, and reaction to skin irritation have been conflicting. No significant differences in corneocyte size, skin thickness, and skin biomechanics have been reported.     

皮肤病与性病学教学方法体会

在皮肤病与性病学的临床教学中,为了激发学生的学习兴趣和热情,提高教学质量,采用多媒体直观形象教学、前瞻性教学、启发式教学、病例讨论式教学、以问题为中心教学等多种生动形象的教学方法进行教学改革,取得满意效果。     

外阴尖锐湿疣与外阴假性湿疣的鉴别诊断及治疗

1外阴尖锐湿疣由人乳头瘤病毒引起,主要通过性接触传播,常与淋病等性病并发,少数人也可能通过有病毒传染的妇女卫生用品和公共浴池浴巾,游泳衣等交叉感染。1.2分布外阴尖锐湿疣最初常见于阴道口,以后向周围蔓延,累及小阴唇、阴道前庭、尿道口、阴蒂或向后累及会阴和肛门周围。皮疹为淡红色细长的突出物,散在或成片排列如毛刷样,常为多数性,可融合成乳突或菜花样,这时皮疹表面常有糜烂及分泌物。3%醋酸涂布后病变区变白色。1.3病理改变尖锐湿疣的表皮都有不同程度的棘细胞层增生肥厚,并向表面突出形成乳头瘤样改变,表层有明显或灶性的角化不…