毛囊单位提取术修复瘢痕性眉缺损疗效观察

目的 观察毛囊单位提取术修复瘢痕性眉缺损的效果.方法 郑州市第一人民医院整形外科用FUE单株毛囊移植技术治疗30例瘢痕性眉缺损患者,包括女18例,男12例,共41处眉缺损.在耳后及颞部提取长度为5～ 10 mm的细软毛发,在6倍显微镜下进行显微分割,制备成单根毛囊进行移植,移植密度为20 ～ 30毛囊单位/cm2.结果 术后随访3～18个月,缺损区眉毛生长方向自然,外形良好,成活率达90％,患者对手术效果满意.结论 毛囊单位提取术是治疗瘢痕性眉缺损的较理想方法,创伤小、成活率高.     

Pattern of Dermatoses Among Nicobarese in a Community Health Camp at Nancowry,Andaman and Nicobar Islands

Background:The Andaman and Nicobar Islands are a group of islands to the east of the Indian mainland. The Nicobar district in its southern part includes the Nancowry group. Very little is known about the dermatoses in this remote region and hence, this study was carried out at a community medical camp held in Kamorta on November 12, 2014.Aims:To study the pattern of dermatoses in Nicobarese attending a community medical camp at Nancowry.Results:A total of 375 patients were seen. Out of these, 113 cases (30.13%) had a skin disorder. Females comprised 50.44% and males 49.56% of the cases. The mean age was 21.28 years. The most common dermatoses were infections and infestations comprising 53 cases (46.9%) of which fungal infections were seen in 25 cases (22.12%), pyodermas in 12 cases (10.62%), scabies in 9 cases (7.96%), warts in 4 cases (3.54%), 1 case each of molluscum contagiosum, herpes zoster, and pediculosis capitis (0.88%) followed by eczema in 20 cases (17.70%), acne in 13 cases (11.5%), papular urticaria in 9 cases (7.96%), and psoriasis in 3 cases (2.65%). Miscellaneous dermatoses made up the rest of the 15 cases (13.27%).Conclusion:The pattern of dermatoses seen among the Nicobarese is quite similar with respect to the prevalence of infections in other regions of India, especially humid regions such as Assam, coastal Karnataka, and Kolkata and much higher than arid regions such as the deserts of Rajasthan.     

Leiomyoma cutis: a clinicopathological series of 37 cases

Background:

Cutaneous leiomyomas are benign smooth muscle tumors that comprise three distinct types such as piloleimyoma, angioleiomyoma, and genital leiomyoma.

Aim:

The objective of this study was to report a series of cases seen in last 8 years in a tertiary care hospital in north India and to discuss their clinicopathologic findings.

Material and Methods:

Paraffin-embedded blocks of cases reported as cutaneous leiomyoma from 1999 to 2007 were retrieved from the Institute of Pathology, New Delhi, and their clinical parameters were noted. Their histopathological features were reviewed on hematoxylin-eosin stained slides. Immunohistochemistry was performed where necessary.

Results:

Twenty-seven cases of piloleiomyoma, three cases of angioleiomyoma, five breast leiomyomas, and two scrotal leiomyomas were seen in patients ranging from 21 to 65 years of age, with an average of 38.2 years at presentation. There was a male predominance with 26 males and 11 females (M:F = 2.2:1). Solitary lesions (n = 21) were more common than multiple ( n = 16). The trunk and upper limbs were involved most commonly, comprising 23 of 37 (62.2%) cases. This was followed by lower limb, face, breast, and scrotum.

Conclusion:

Cutaneous leiomyomas are rare lesions and form an important clinical differential diagnosis of painful papulonodules. These must be biopsied in order to differentiate them from other spindle cell lesions.     

Papular Acantholytic Dyskeratosis Localized to the Perineal and Perianal Area in a Young Male

A case of Papular acantholytic dermatosis restricted to the perianal area is being reported in a 26 year old male without involvement of the genitalia, groin and upper thighs for the first time in English literature. The patient presented with long standing grayish white confluent papules with eroded areas in the perianal region which were asymptomatic for a long time before the area got macerated. He did not respond to many weeks of topical steroids but is now showing improvement with topical tacrolimus ointment 0.1% applied twice daily. This entity appears to be very uncommon and also underreported. It is also suggested that this entity be included in the long list of non venereal anogenital lesions as it may mimic perianal warts or molluscum contagiosum.     

Oral Lichen Planus: An Update on Etiology,Pathogenesis, Clinical Presentation,Diagnosis and Management

The mouth is a mirror of health or disease, a sentinel or early warning system. The oral cavity might well be thought as a window to the body because oral manifestations accompany many systemic diseases. In many instances, oral involvement precedes the appearance of other symptoms or lesions at other locations. Oral lichen planus (OLP) is a chronic mucocutaneous disorder of stratified squamous epithelium of uncertain etiology that affects oral and genital mucous membranes, skin, nails, and scalp. LP is estimated to affect 0.5% to 2.0% of the general population. This disease has most often been reported in middle-aged patients with 30-60 years of age and is more common in females than in males. The disease seems to be mediated by an antigen-specific mechanism, activating cytotoxic T cells, and non-specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. A proper understanding of the pathogenesis, clinical presentation, diagnosis of the disease becomes important for providing the right treatment. This article discusses the prevalence, etiology, clinical features, oral manifestations, diagnosis, complications and treatment of oral LP.     

GIANT CUTANEOUS HORN

A 53-year-old male presented with a giant cutaneous horn over the left leg. Cutaneous horn was excised and primary closure of the defect was done under spinal anesthesia. Histopathology showed underlying seborrheic keratosis. Cutaneous horn has been noticed on top of many clinical conditions of diverse etiology, such as actinic keratoses, wart, molluscum contagiosum, seborrheic keratoses, keratoacanthoma, basal cell and squamous cell carcinoma. We report a patient with giant cutaneous horn on the leg successfully treated by excision and wound closure.     

Limits of fine-needle aspiration cytology in diagnosing pilomatrixoma: a series of 25 cases with clinico-pathologic correlations

Background:

Pilomatrixoma (PMX) is a benign, quite uncommon, skin neoplasm, which is frequently misdiagnosed by clinicians.

Aim:

We have analyzed 25 PMX to determine the agreement between clinical diagnosis, preoperative FNA characteristics, and corresponding histopathological specimens; moreover, reliable cytologic criteria for PMX and the differential diagnosis to avoid cytological pitfalls have been emphasized.

Materials and Methods:

By fine-needle aspiration (FNA) cytology a series of consecutive cases of PMX collected during last 5 years were studied. Smears were stained by Papanicolau and May-Grünwald-Giemsa.

Results:

Patients affected by PMX were 11 males, 14 females (ratio 1:1.27); the mean age was 32.72 years with age range 3-78 years, being 72% (18/25) of patients 40 years or less. PMX was mainly distributed in the head-neck region (52%), scalp (16%), upper/lower arms (28%), and chest (4%). The observed diagnostic cytological features were represented by clusters of basaloid epithelial cells, shadow or ghost cells, inflammatory background, calcification, and giant cells. Unfortunately, not all these morphological aspects were always disclosed in smears, thus making the cytological preoperative diagnosis questionable and problematic.

Conclusions:

The experience of a well-trained cytopathologist should distinguish the relevant FNA features in terms of smear background, architecture, and cell morphology. The most dangerous mistake in FNA diagnosis of PMX regards a diagnosis of primary malignant or metastatic cutaneous lesions.     

Eyebrow threading: a popular hair-removal procedure and its seldom-discussed complications

Removal of eyebrow and facial hair by 'threading' has gained popularity worldwide. Threading is an ancient Eastern method of removing unwanted facial and eyebrow hair by a technique whereby one end of a cotton thread is held in the mouth of the technician and the other end looped around individual hair shafts, which are then pulled out. This is repeated in quick, successive movements. In India, this is used extensively for shaping and removing eyebrow hair. Threading now enjoys immense popularity with women worldwide, irrespective of race or colour, and is an accepted method for removing eyebrow hair and shaping the eyebrows. However, this popular cosmetic procedure has some significant dermatological side-effects and is not familiar to many dermatologists. To our knowledge, this is the first report of verrucae occurring in threaded eyebrows. Other complications include erythema, folliculitis, pseudofolliculitis, hyperpigmentation, and depigmentation, including koebnerization of vitiligo. This report should alert dermatologists to the possible complications that may arise from this popular aesthetic epilatory procedure.     

Synophrys: The societal implications of the bad ol’ unibrow

The complete or partial meeting of medial eyebrows at midline above the bridge of nose, forming a single band of hair, is known as synophrys or unibrow. With a few rare exceptions, when it may serve as a cutaneous marker lesion of several genetic disorders, with Cornelia De Lange syndrome being the commonest, synophrys is usually a normal variation. Although various cultures have prized synophrys as an attractive physical trait throughout history, in modern Western culture, the unibrow is frequently regarded as an undesirable and unappealing feature with negative connotations.Synophrys, derived from the Ancient Greek σύν (together, with) and ὀφρύς (eyebrow), meaning “with meeting eyebrows,” refers to the complete or partial fusion of medial eyebrows at midline. The hair above the nasal bridge is often of the same color and thickness as the eyebrows, thus giving the appearance that they converge to form one uninterrupted line of hair, a single eyebrow.     

Thyroid Disorders Associated with Alopecia Areata in Egyptian Patients

Context:

Alopecia areata (AA) is a common form of localized, non-scarring hair loss. The etiopathogenesis of the disease is still unclear, but the role of autoimmunity is strongly suggested. AA is commonly associated with various autoimmune disorders; the most frequent among them is autoimmune thyroid disorders.

Aim:

To determine whether AA is associated with thyroid autoimmunity or thyroid function abnormalities in Egyptian patients.

Materials and Methods:

Fifty subjects with AA (37 males and 13 females) without clinical evidence of thyroid disorders were selected from Dermatology Outpatient Clinic, Menoufiya University Hospital, Menoufiya Governorate, Egypt, during the period from June 2009 to February 2010. They were divided into 3 groups according to severity of AA. Fifty age and sex-matched healthy volunteers (35 males and 15 females) were selected as a control group. Every case and control were subjected to history taking, complete general and dermatological examination. Venous blood samples were taken from cases and controls after taking their consents for measurement of thyroid stimulating hormone (TSH), free T3, freeT4 and detection of Anti-thyroglobulin Antibody (Tg-Ab) and Anti-thyroid Peroxidase Antibody (TPO-Ab).

Results:

Subclinical hypothyroidism was detected in 16% of cases. There were statistically significant differences between cases and controls regarding levels of TSH, free T3 and free T4. There were significant differences between cases and controls regarding the presence of Tg-Ab and TPO-Ab.

Conclusions:

Every patient with AA should be screened for thyroid functions and presence of thyroid autoantibodies even in absence of clinical manifestations suggestive of thyroid affection.     

Eyebrow bleaching among females: a cross-sectional study

Background Eyebrow bleaching is a common practice among women with dark hair that allows for alterations in the eyebrows’ shape without the use of hair removal. A literature search on this topic failed to reveal any extant studies. Objective To explore the prevalence, associated motives, and side effects of eyebrow bleaching among women. Methods A questionnaire about eyebrow bleaching was distributed randomly to female patients attending the outpatient clinics at a university hospital between June and August 2008. Results The response rate was 87.2%; with 567 of the 650 distributed questionnaires returned. The mean age was 32.01 ± 10.17 years. 48.4% (253/522) of the participants reported having bleached their eyebrows. Of these individuals, 55.8% (101/181) experienced side effects related to eyebrow bleaching. These side effects included increased or decreased density of the eyebrow hair, and redness, itching, and scaling of the eyebrow skin. The motives behind eyebrow bleaching varied widely, but were primarily esthetic in nature. Younger women, students, and participants with higher monthly incomes reported bleaching their eyebrows a greater number of times than others (P < 0.001, 0.04 and 0.003, respectively). Conclusion In this sample of female patients, eyebrow bleaching was reported to be a common practice. Bleaching was associated with local side effects in over 50% of those who use the technique. Thus, there is a need to educate the public about these side effects.     

Genital vitiligo following use of imiquimod 5% cream

Imiquimod is a small molecule with adjuvant pro-inflammatory effects that can be topically delivered as a cream for treating external genital and perianal warts. In our report, two Chinese males at the ages of 25 and 22 years were treated with imiquimod 5% cream for recurrent condyloma accuminatum, three times per week for 18 and 12. weeks, respectively. Depigmentation were noted and gradually enlarged in the treated areas after the two patients discontinued imiquimod. Therefore, clinicians should be made aware of the possible pigmentary changes associated with application of this cream.     

文眉致白癜风七例

【摘要】 目的 报道文眉所致白癜风7例。方法 收集2017年12月至2019年5月河南省人民医院皮肤科诊治的7例文眉引起的白癜风,回顾其临床特点。结果 7例患者文眉后1个月至1年出现数根眉毛变白,早期均表现为眉毛变白,眉部皮肤正常,眉周逐渐出现白斑,边界不清。眉部皮损反射式共聚焦扫描显微镜特征：基底层及毛囊周围色素缺失,真皮浅、中层可见高折光无定形物（色料）。斑贴试验：文眉色料均为阴性,十二醇硫酸钠均呈阳性。结论 文眉后引起的白癜风,早期眉部皮肤未见色素减退斑,结合眉部皮损反射式共聚焦扫描显微镜特征可减少误诊。     

Evaluation and Management of Polymyositis

Polymyositis (PM) is one of the inflammatory myopathies, disorders characterized pathologically by the presence of inflammatory infiltrates in striated muscle. The principal clinical manifestation of PM is proximal muscle weakness. The cause of PM is unknown, but current evidence suggests that it is an autoimmune disorder. PM can affect people of any age, but most commonly presents between the ages of 50 to 70. PM is rarely seen in people younger than 18 years of age, and is twice as common among females than males. PM is more common in blacks than in whites. The overall prevalence of PM is 1 per 100,000. Muscle weakness may develop suddenly or more insidiously over a period of weeks to months. The classic symptom of PM is proximal weakness, which may manifest as difficulty holding the arms over the head, climbing stairs, or rising from a chair. Weakness of the striated muscle of the upper esophagus may result in dysphagia, dysphonia, and aspiration. The chest wall muscles may be affected, leading to ventilatory compromises. Involvement of cardiac muscle may lead to arrhythmias and congestive heart failure. Dermatomyositis (DM) is closely related to PM, and both are distinguished primarily by the occurrence of characteristic skin abnormalities in the former. PM and DM may be associated with a variety of malignancies. PM may also occur as part of the spectrum of other rheumatic diseases like systemic lupus erythematosus and mixed connective tissue disease. Moreover, inflammatory myopathy may be caused by some drugs (procainamide, D-penicillamine), and viruses, most notably the retroviruses. Corticosteroids and immunosuppressive agents are the mainstays of therapy for PM. The principal goals of therapy are to improve strength and improve physical functioning. Many patients require treatment for several years. The 5-year survival rate for treated patients is in the order of 95%. Up to one-third of PM patients may be left with some degree of residual muscle weakness.     

Giant seborrheic keratosis of the genitalia

Genital seborrheic keratosis (SK) is a rare entity, which can be easily misdiagnosed as genital warts. Dermoscopy is a useful tool to make diagnosis of SK in such cases. We report a 50-year-old woman with a large polypoidal growth on the external genitalia. Dermoscopic examination showed fissures and ridges, cerebriform appearance, and comedo-like openings consistent with SK. The histopathology confirmed the diagnosis of SK.     

Etiopathogenesis and Therapeutic Approach to Adult Onset Acne

Acne vulgaris is usually considered as a skin disorder that primarily affects adolescents reaching a peak at the age of 14–17 years in females and 16–19 years in males. However, recent epidemiologic studies have shown that a significant number of female patients aged >25 years experience acne. As it is regarded as a disease of teenagers, adults are more apprehensive and experience social anxiety. Hence, adult onset acne has become a matter of concern.