获得性淋巴管扩张症

报告1例获得性淋巴管扩张症。患者女,63岁。因左上臂近端内侧无症状小水疱5年就诊。10年前,患者因患左乳腺癌行左乳切除术。皮损组织病理检查示真皮有许多扩张的管腔,管腔内未见红细胞。免疫组化检查示管腔内的扁平内皮细胞CD31和D2—40（淋巴管特异性标志抗体）阳性,而CD34和FⅧ阴性。符合获得性淋巴管扩张症的诊断。     

获得性局限性毛增多症一例

患儿，男，7岁，3+月前因左下肢骨折行小夹板+钢丝托板外固定术，拆除后左小腿出现毛发增多、变粗、变长。诊断为获得性局限性毛增多症。     

Acquired hypertrichosis lanuginosa: a case report

The authors present a patient with hypertrichosis lanuginosa acquisita without associated malignancy.     

获得性局限性皮肤松弛症一例

患者,女，24岁。面颈部皮肤逐渐松弛2年。皮肤科查体：面颈部、双上眼睑皮肤松弛下垂，呈早老外观。疲劳试验（-）。皮损组织病理学检查示真皮层弹性纤维减少，形态异常，呈扭曲状。诊断：获得性局限性皮肤松弛症。     

获得性丛状血管瘤一例

<正>临床资料患者,女,19岁。因右侧乳房多发暗红色斑块、结节伴疼痛3年就诊。患者3年前无明显诱因右侧乳房出现暗红色斑块、结节,逐渐增多,边界不清,伴有触压痛,部分皮疹自行消退,消退后见色素沉着斑,未检查及治疗。近半年来,乳房斑块增大,触痛明显,遂来我院门诊就诊。既往体健,自发病来无体重减轻。局部无外伤、手术及输血史,无药物及食物过敏史,无类似疾病家族史。体格检查:一般情况良好,各系统检查无异常。皮肤科检查:右侧乳房多发暗红色斑块、结节     

Acquired periungual fibrokeratoma: a case report

Acquired periungual fibrokeratoma (APF) is an uncommon lesion located around the nail and related to acquired digital fibrokeratoma. Histologic features of APF include a core of thick collagen bundles oriented along the longitudinal axis of the tumor and a very characteristic pseudo-nail plate formation. Different terms have been used to describe these lesions, and there has been no consensus on the terminology for some years. It is now believed that trauma may play a role in the pathogenesis of these periungual lesions.     

成人获得性锌缺乏症1例

 报告1例成人获得性锌缺乏症。患者女,55岁,眼周及口周皮疹1个月,双手足水疱10余天。皮肤科检查：头发稀疏、颜色正常;双眼周、口周见红色斑疹、斑片及鳞屑;双手掌及手腕、双足底、足趾见红斑基础上水疱、大疱,疱壁厚,疱液澄清,尼氏征阴性,部分破溃结痂;肛周、骶尾部见多处破溃后红色糜烂面。腹部及四肢见散在红色斑疹、褐色痂皮,口腔及生殖器黏膜未累及。实验室检查：血清锌70.05 μmol/L,碱性磷酸酶＜20 U/L。皮损组织病理：轻度角化过度,表皮轻度增生,灶性细胞内细胞间水肿,局部形成小水疱,真皮浅中层血管周围少量淋巴细胞浸润。诊断：获得性锌缺乏症。治疗：予以口服葡萄糖酸锌溶液及营养支持疗法,皮损1周内缓解。随访3个月未见复发。     

大疱性类天疱疮合并获得性血友病一例

获得性血友病A(acquired hemophilia A, AHA)死亡率为15%～42%,约50%左右的AHA为特发性,而另外50%与一些基础疾病有关,如系统性红斑狼疮、肿瘤、药物过敏、皮肤病(如银屑病,大疱性类天疱疮)等。本文报道一例大疱性类天疱疮合并获得性血友病,采用泼尼松、人凝血酶原复合物联合环孢素治疗后取得了显著疗效。     

获得性丛状血管瘤二例

例1女,18岁.右大腿红斑10年,缓慢扩大,无自觉症状.皮肤科检查:右大腿伸侧大片红褐色斑,有轻度浸润感,触之稍硬,边界不清.例2女,43岁,左侧肘窝红斑、丘疹及结节3年余,自觉瘙痒.皮肤科检查:左肘窝可见大片黄红色斑疹,表面可见多个大小不一的红色丘疹结节,部分融合成条索状,边界清楚,表面光滑,触之痛.2例皮损组织病理检均显示:表皮正常,真皮浅中层散在分布多个由毛细血管组成的小叶样结构,境界清楚,低倍镜下呈炮弹样分布,血管腔内衬扁平的内皮细胞,外围由周细胞环绕,部分小叶周围可见新月形或半月形扩张的淋巴管.     

Acquired idiopathic generalized anhidrosis: case report

We report a case of acquired idiopathic generalized anhidrosis (AIGA) in a 56-year-old white woman. Acquired idiopathic generalized anhidrosis is an exceedingly rare group of heterogeneous disorders that has been almost exclusively reported in young Japanese males. Our case is unique in that AlGA may be underrecognized in this patient population.     

Acquired patch-type blue nevus with overlying vitiligo: a case report

Background Blue nevi are a group of congenital and acquired dermal melanocytoses characterized by a blue‐gray appearance on the skin. The common blue nevus and cellular blue nevus are the most common subtypes. Patch‐type blue nevus is rather rare. Observations We describe a 77‐year‐old Chinese male with a 6 × 8‐cm non‐palpable blue patch overlaid by a depigmented patch on the back of the left scalp. Histological examination of the blue‐gray patch showed numerous spindled and elongated bipolar dendritic melanocytes in the upper reticular dermis and an absence of epidermal melanocytes. Immunohistochemically, these dendritic melanocytes were positive for S‐100 and HMB‐45. A diagnosis of a patch‐type blue nevus with overlying vitiligo was made after the biopsy. Conclusions The patient presents an unusual manifestation of patch‐type blue nevi with overlying vitiligo. To the best of our knowledge, these features have not been previously described.     

获得性梅毒性颅骨炎合并梅毒性脑膜炎

报告国内首例获得性梅毒性颅骨炎合并梅毒性脑膜炎.患者女,55岁,2个月前无诱因于头顶部和枕部出现持续性胀痛.磁共振成像T1加权像提示:颅骨多发性病变,邻近脑膜线状强化.查血快速血浆反应素环状卡片试验(RPR)1:32阳性,梅毒螺旋体明胶凝集试验(TPPA)阳性;脑脊液检查:白细胞10×106/L,蛋白0.82 g/L,RPR 1∶4阳性,TPPA阳性;额骨骨膜梅毒螺旋体DNA阳性.组织病理示:颅骨灶性溶骨性破坏,骨纹理模糊,碎骨组织周围和硬膜样组织充血,间质纤维组织增生,内皮细胞肿胀,大量浆细胞为主炎细胞浸润.治疗:按神经梅毒的治疗方案治疗,头痛于治疗3d后缓解,15d后基本消失,30 d后完全消失,之后未再出现类似的头痛.随访5年,近期疗效和远期疗效均满意.最终诊断:梅毒性颅骨炎合并梅毒性脑膜炎.     

Acquired bullous dermatosis associated with IgA multiple myeloma: a case report

We present the case of a patient with IgA paraprotein who developed hemorrhagic subepidermal vesicles and bullae with numerous neutrophils. Direct immunofluorescence test (DIF) showed weak deposits of IgA lambda paraprotein at the dermal–epidermal junction and at the intercellular level in the basal layer of the epidermis, and stronger deposits in a perivascular and diffuse pattern in the dermis. Indirect immunofluorescence (IIF) test revealed the presence of circulating IgA lambda antibodies reacting with the intercellular space of monkey and guinea pig esophagus and human skin. A blood test revealed an IgA lambda paraprotein and multiple myeloma stage I(0) was diagnosed in a later hematological study. Dapsone was prescribed and cutaneous lesions improved. This is the second report of subepidermal vesicles and bullae with dermal deposits of IgA paraprotein appearing prior to diagnosis of an IgA multiple myeloma, and it is a unique case with circulating IgA lambda antibodies reacting with the intercellular space of epithelia. Barnadas MA, Gelpí C, Martínez L, Curell R, Martino R, Alomar A. Acquired bullous dermatosis associated with IgA multiple myeloma: a case report.     

Acquired haemophilia in a patient with systemic lupus erythematosus

INTRODUCTION: In patients with lupus, the most common acquired circulating anticoagulant is antiprothrombinase which is responsible for thrombosis. The presence of antibodies directed against factor VIII is rarely found in systemic lupus erythematosus. A case of acquired haemophilia in a patient with lupus is reported. CASE REPORT: A 30 year-old woman with systemic lupus erythematosus developed a right coxalgia and ecchymotic skin lesions which were prominent on the right arm and forearm. Laboratory values were as follows: positive antinuclear antibodies > 1: 2 560, anti-DNA antibodies (300 IU/ml), prolonged activated partial thromboplastin time, reduced factor VIII activity (1 p. 100) and the presence of antibodies against factor VIII. Magnetic nuclear resonance of the right hip confirmed the presence of an intramuscular hematoma. The patient was initially treated with intravenous pulse and oral corticosteroids, intravenous immunoglobulins and intravenous cyclophosphamide. Clinical and biological improvement was promptly obtained. DISCUSSION: In our patient with systemic lupus erythematosus, bleeding revealed acquired haemophilia with antibodies against factor VIII. It should be pointed out that the association between lupus and haemophilia is uncommon and that at present no standardized treatment can be recommended.     

获得性反应性穿通性胶原病合并糖尿病及银屑病一例

<正>反应性穿通性胶原病是一种以变性胶原被排出体外为特征的穿通性皮肤病,临床少见,多累及儿童,有一定遗传倾向。成人期发病的患者多合并系统疾病。我科诊治1例获得性反应性穿通性胶原病合并银屑病、糖尿病的患者,现报道如下。临床资料患者,女,66岁。因全身丘疹、斑块、鳞屑伴痒1年,溃疡6个月来诊。1年前患者躯干、四肢开始出现丘疹、斑块、鳞屑,伴瘙痒。曾于外院诊断"银屑病",治疗不详,病情无好转。6个月前,双下肢开始出现散在的绿豆大脐凹状溃疡,于     

Acquired acrodermatitis enteropathica: case report of an atypical presentation

Acrodermatitis enteropathica (ADE) is a rare genetic or acquired disorder of hypozincemia. It can be caused by impaired intestinal absorption of zinc or by poor consumption of the mineral. It is characterized by skin lesions on acral and periorificial areas and may be associated to alopecia, diarrhea and increased frequency of infections. We present an atypical presentation of ADE in a 33-year-old women with a history of mental retardation and psoriasis that presented with lesions on the periorificial areas and extremities, and low plasma zinc levels.     

Acquired vulvar smooth muscle hamartoma: a case report and review of the literature

A 36-year-old Korean woman had had a flesh-colored, indurated plaque with pruritus on the labium majora for five years. The lesion was not found in association with hyperpigmented or hypertrichotic patches. Results of biopsy specimens showed an excess of haphazardly oriented smooth-muscle bundles in the mid to lower dermis with an unremarkable overlying epidermis. Our diagnosis was an acquired smooth-muscle hamartoma in the vulva. Although there have been previously reported cases of acquired smooth-muscle hamartoma, this was the first reported case in the vulva. We also describe the characteristics differing between our case and the six previously reported ones.