皮肤隐球菌1例报道

患者男性，12岁，因肾病综合征给予大剂量甲基强的松及环磷酰胺冲击治疗，继发面及前臂的多发性传染性软疣样皮疹，真菌学检查和组织病理证实为皮肤隐球菌病，给予氟康唑治疗无效，患者9天后死于急性肾功能衰竭。     

手术治愈面部隐球菌病1例

皮肤隐球菌病为少见的深部真菌感染性疾病，原发于口腔颌面部的感染尤为少见。临床上极易误诊，笔者遇到1例面部原发性皮肤隐球菌病，经细菌学培养及皮肤组织病理检查确诊，经手术治愈，追踪观察18个月未见复发，现报道如下。     

儿童全身播散性隐球菌病1例

儿童全身播散性隐球菌病１例刘德明，曾庆玉，王华隐球菌病是由新生隐球菌引起，全身播散性损害罕见，最近我们收治１例有皮肤、淋巴结、肺、骨及中枢神经系统损害的隐球菌病患儿，现报告如下。患儿胡×，女，６岁。因发热、咳嗽、胸痛６个月，伴有皮疹３个月入院。起病初...     

霉康唑治愈一例原发性皮肤隐球菌病

隐球菌病大部分原发于肺部,常常播及脑膜和脑实质.播散性隐球菌病偶可累及皮肤.原发性皮肤隐球菌病是指皮肤损害是其唯一的表现,而无系统性或脑脊液的侵犯.本病较为罕见,可以在含有新型隐球菌的异物损伤皮下以后而出现.作者报告一例男性患者,81岁,因左前臂红肿痛一个月而就诊.查局部红肿湿润,渗出少量脓液,近卫淋巴结不大.给予红霉素治疗无效,且损害继续扩大,以至形成10×6.5cm溃疡.检查肺、神经系统及其他系统无异常.溃疡区活检表现为慢性炎症,可见多数淋巴细胞、组织细胞和少数多形核白细胞浸润.有多数胶样厚荚膜孢子,偶见巨细胞.溃疡组织在沙氏葡萄糖琼脂培养为新型隐球菌生长.此时作痰、尿、脑脊液直接镜检和培养均为阴性.遂     

皮肤隐球菌病合并隐球菌性脑膜炎一例

人类的隐球菌病.约110%-15%有皮肤损害.我科收治1例以肉芽肿损害为主的皮肤隐球菌病合并隐球菌性脑膜炎的患者.现报告如下.     

隐球菌病的诊治

隐球菌病(cryptococcosis)是一种重要的世界性人兽共患的感染性真菌病,可侵犯人体的肺、脑、皮肤、骨骼等全身各脏器。因其强烈的嗜中枢性,所致的隐球菌性脑膜炎/脑膜脑炎(cryptococca meningitis/meningoencephalitis,CME)约占隐球菌感染的80%以上,具高病死率。现从流行病学、临床表现、实验室诊断及治疗几方面阐述隐球菌病诊治方面的进展。     

特发性CD4+T淋巴细胞减少症伴播散性皮肤隐球菌病

患者女，23岁，左锁骨、腰部右侧及左膝部出现肿块并溃疡4个月，组织病理检查示组织中大量浆细胞及异物巨细胞；PAS染色显示大量散在或成团的孢子，经鉴定证实为新生隐球菌，连续T淋巴细胞亚群分析显示CD4^ T淋巴细胞明显减少，占总T淋巴细胞数20％以下．无人类免疫缺陷病毒(HIV)感染，诊断为特发件CD4^ T淋巴细胞减少症伴播散性皮肤隐球菌病．主要给予两性霉素B治疗，1个月后溃疡愈合．     

发生于艾滋病患者的Kaposl肉瘤样皮肤隐球菌病

kaposi肉瘤及播散性隐球菌病在一般人群中均罕见,但在免疫受损的患者中发病率明显增加.本文报告1例艾滋病(AIDS)患者,患有口腔Kaposi肉瘤及播散性皮肤隐球菌病.患者41岁,     

肾移植患者播散性隐球菌病致广泛皮下结节1例

患者女性34岁，行肾移植术后6年，一直使用免疫抑制剂治疗。不明原因发热7天入院。体检：体温38℃，患者背部皮肤广泛3cm至6cm大小不等皮下结节，表面皮肤未见破损，呈红色、偏硬、有压痛。皮肤组织活检见深达赵皮层急性肉芽肿性炎，炎症组织中弥漫酵母样细胞。经培养鉴定并查血、脑脊液培养鉴定均可见新生隐球菌生长，诊断为播散性隐球菌病。予氟康唑200mg每日静脉滴注治疗。患者体温消退，皮疹也逐步消退。     

艾滋病并发播散性皮肤隐球菌病

报告1例艾滋病并发播散性皮肤隐球菌病。患者女,32岁。人免疫缺陷病毒(HIV)抗体阳性,无系统感染症状,皮损表现为传染性软疣样。皮损组织病理示组织细胞内外可见大量有荚膜的孢子,PAS染色阳性。皮损真菌培养阳性,菌种鉴定为新生隐球菌。治疗给予氟康唑静脉滴注,半个月后原有皮损结痂愈合,但右背部又新发带状疱疹。     

An unusual case of coccidioidomycosis presenting with skin lesions

A 42-year-old white male without prior skin disease presented 8 months ago with chest pain, fever, and coughing to his primary physician. At that point, he had no skin lesions. The diagnosis was made by standard blood tests. The patient completed treatment and was symptom free for 8 months until he presented to his physician again with skin lesions on his right cheek and extremities. The patient was referred to our dermatology clinic for further evaluation. A complete skin examination revealed lesions on his face, extremities, and back. The lesions on his right face were 8 x 10-mm erythematous papules and nodules coalescing into a plaque. A biopsy was taken from his right cheek lesions.     

继发于重型痘疮样水疱病的角化棘皮瘤1例

患者男性，41岁，自3岁始于日日本 后暴露部位起皮疹，反复发作，致畸。诊断为重型种痘样水疱病，患者31岁时终止发病，同年右耳廓发生角化棘皮瘤，手术切除治愈。     

A case of anti-epiligrin cicatricial pemphigoid associated with lung carcinoma and severe laryngeal stenosis: review of Japanese cases and evaluation of risk for internal malignancy

A 68-year-old Japanese male with a five-year-history of lung carcinoma showed recurrent blisters and erosions on the oral and genital mucosae and the skin. The patient complained of dyspnea due to severe laryngeal stenosis and underwent a tracheostomy. A skin biopsy specimen showed a subepidermal blister and linear deposits of IgG and C3 at the basement membrane zone of the epidermis. Indirect immunofluorescence examination demonstrated circulating IgG anti-basement membrane zone autoantibodies that reacted to epiligrin on immunoblotting. Based on a diagnosis of anti-epiligrin cicatricial pemphigoid, he was treated with prednisolone, minocycline hydrochloride and nicotinamide. Although no new skin lesions appeared, he died of lung carcinoma five months after the tracheostomy. A review of reported cases with anti-epiligrin cicatricial pemphigoid in Japan disclosed that 5 of 16 cases (31.2%) were complicated by internal malignancies.     

复发前后皮损表现不同的性病型Reiter综合征

报告1例复发前后皮损表现不同的性病型Reiter综合征.患者男,50岁.在多次非婚性生活后,出现尿道炎、不对称性关节痛、结膜炎及全身皮损,诊断为性病型完全型Reiter综合征.在病情稳定1年余后,在多次非婚性生活后再次出现全身皮损,复发皮损与初发不同,因此该例诊断为性病型Reiter综合征复发.     

Atopic dermatitis without serum immunoglobulin E elevation or loss-of-function filaggrin gene mutation in a patient with X-linked agammaglobulinemia

A case of atopic dermatitis (AD) with X-linked agammaglobulinemia (XLA), which is one of the primary immunodeficiency diseases, is reported. A 12-year-old boy had suffered from dry skin and recurrent itchy eruptions since he was 2 years old, and he was diagnosed as having XLA at the age of 4 years. His total immunoglobulin (Ig)E level was 7 IU/mL, even with regular Ig replacement therapy. Furthermore, filaggrin (FLG) mutations known in the Japanese population were not found. His skin lesions were well controlled by the application of a mild-class topical steroid and a moisturizer, though he developed folliculitis due to Staphylococcus aureus infection during treatment with a strong-class topical steroid. This case suggests that the FLG mutation and IgE-mediated sensitization are not necessary to induce AD skin manifestation.     

Scarring Due to an Enuresis Blanket

A 7-year-old boy was examined for cutaneous lesions that were localized to the side of the body on which he slept and occurred on skin in direct contact with an enuresis blanket. The painless skin lesions were similar to the punched-out skin ulcers and atrophic scars reported in the British literature as buzzer ulcers. Exposure of the child's skin to electrical current may have produced the lesions, which ceased to appear when use of the enuresis blanket was discontinued.     

Basiliximab treatment of severe GVHD induced by donor lymphocyte infusion with interferon‐a

The development of acute graft‐versus‐host‐disease (GVHD) in recipients of donor lymphocyte infusion (DLI) is not rare and the complication is quite often fatal. We describe a severe skin GVHD patient who responded well to basiliximab. A 20‐year‐old male who received a hematopoietic stem cell transplantation at his age of 18. His fusion gene Aml1/Eto remained positive, so he was administered with DLI combined with interferon‐a (IFN‐a). Forty days after the therapy, he presented with severe skin rashes with multiple mucous membrane involvement. The skin and mucous lesions recovered after basiliximab treatment. So far, severe type of erythema multiforme in GVHD patients after DLI with IFN‐a injection is firstly reported here, together with a new alternative therapy.     

Piroxicam photosensitivity associated with vesicular hand dermatitis

A case of piroxicam photosensitivity in a 42-year-old man is reported. While he was taking piroxicam, eczematous skin lesions on sun-exposed skin and vesicular hand dermatitis on the finger webs and palms developed. He showed a lowered minimal erythema dose (MED) to UVA when a rechallenge with piroxicam was attempted. Photopatch testing with piroxicam was positive.     

Multiple extra-medullary plasmacytomas of the skin

Multiple plasma cell tumours of the skin may, on rare occasions, precede clinical, radiological and laboratory evidence of systemic myelomatosis. A man presented with several plasma cell tumours of the skin but with no detectable evidence of the disseminated myelomatosis to which he succumbed 16 months later. Multiple cutaneous extra-medullary plasmacytomas should be regarded as a cutaneous expression of multiple myelomatosis.     

Dyschromatosis universalis hereditaria. An unusually rare clinical picture

A 30-year old male patient presented with a rare congenital pigment disturbance, dyschromatosis universalis hereditaria. Clinically, he displayed mottled hyperpigmentation covering almost the entire skin surface with accentuation in skin folds. The lesions had been present since birth. He was the only family member showing these changes. He had no other medical problems and took no medications.