多发性骨髓瘤并发坏疽性脓皮病

报告1例多发性骨髓瘤并发坏疽性脓皮病.患者女,58岁.4个月前左下肢出现丘疹、斑块及溃疡,伴有疼痛和瘙痒.皮损组织病理检查示白细胞碎裂性血管炎.血清中检查出单克隆IgA λ链免疫球蛋白区带.骨髓穿刺检查示浆细胞及幼稚浆细胞增多.诊断:多发性骨髓瘤并发坏疽性脓皮病.     

坏疽性脓皮病1例

坏疽性脓皮病是一种慢性复发性溃疡性皮肤病，皮损形态和组织病理有一定特征。但病因不明，常合并系统性损害如炎性肠病、关节炎、肿瘤等。现将笔者遇到的1例报告如下。     

1例多发性坏疽性脓皮病的护理体会

坏疽性脓皮病是一种少见病，临床治疗护理困难较大。我们在病情演变过程的不同时期，根据皮损不同情况要取了不同的护理措施，特别是使用我院配制的溃疡膏，使溃疡面得到较快愈合。     

坏疽性脓皮病1例

患者男,19岁。因双下肢疼痛性溃疡1个月伴发热半个月,于2004年10月14日入院。患者1个月前无明显诱因双小腿出现疼痛性丘疹、脓疱,挤压后破溃,流出少量脓液,逐渐发展成硬币大溃疡,1个月后增至手掌大。在当地医院取分泌物行细菌及真菌培养均为阴性,诊断为“慢性溃疡”。予以静脉滴注硫酸阿米卡星、地塞米松、头孢拉定等治疗,溃疡面仍逐渐增大。入院体格检查：T39.0℃,系统检查未见异常。     

坏疽性脓皮病1例

报告1例坏疽性脓皮病。患者男,49岁,全身多发结节、溃疡伴疼痛反复发作2年,加重3月。溃疡可自行愈合,形成菲薄的萎缩性瘢痕。组织病理检查符合坏疽性脓皮病表现。给予糖皮质激素及免疫调节剂获良效。     

坏疽性脓皮病18例分析

坏疽性脓皮病是一种少见病,以皮肤坏死、复发性潜行性溃疡为特征,常伴有炎性肠病、关节病和血液病等内在疾病。我院自1986～1996年共收治18例,现分析如下。     

联合治疗坏疽性脓皮病3例

联合治疗坏疽性脓皮病３例蔡惠君（四川攀枝花市中心医院，６１７０６７）例１：男，２７岁、已婚，因下颌两侧长疮反复存在７年。逐渐加重３月。曾以“痤疮感染”先后用过各种抗生素及中药治疗效果不佳。近来皮损逐渐肿大化脓、红肿疼痛不适，颈部功能受限而来我科就诊。...     

面部坏疽性脓皮病1例

坏疽性脓皮病是一种复发性破坏性皮肤溃疡,临床上较少见,现将笔者诊治的1例报告如下。     

皮肌炎合并坏疽性脓皮病一例

患者男,39岁,因面部紫红斑4年,肌无力3年,皮肤深溃疡3个月于2004年2月就诊。患者4年前无明显诱因出现以双眼睑为中心的面部水肿性紫红色斑片,无不适感。3年前颈部及上胸部出现大片红斑,并出现四肢近端肌肉酸痛、乏力,严重时曾出现行走及下蹲困难,饮水呛咳,腰背肌肉酸痛。在外院     

坏疽性脓皮病合并药疹一例

患者女,61岁,因左上胸溃疡伴疼痛 7个月,于2004年12月4日就诊。患者 7个月前发现左锁骨有一蚕豆大小结节, 无不适,到某医院外科求诊,拟脂肪瘤行手术切除。术后常规换药、抗菌治疗,创面无愈合,且其周围逐渐出现反复坏死, 剧烈疼痛,又先后4次拟诊术后感染,窦道形成,行外科手术,术后使用多种抗生素,病情继续恶化。既往史无异常。体检:各系统检查正常。皮肤科检查:左上胸部见-13cm×6cm大小深部溃疡,基底高低不平,深约0．8-2.2 cm,     

下疳样脓皮病伴非淋菌性尿道炎及尖锐湿疣1例

报告1例下疳样脓皮病伴尖锐湿疣及非淋菌性尿道炎。患者男，27岁。临床表现为尿频、尿急、尿痛，全身散在黄豆至蚕豆大梅毒硬下疳样溃疡和阴茎背侧赘生物。既往有非婚性接触史。尿道分泌物衣原体快速检测( )；反复暗视野查梅毒螺旋体及梅毒血清试验均阴性。诊断为下疳样脓皮病伴尖锐湿疣及非淋菌性尿道炎。给予口服米诺环素、左氧氟沙星及盐酸伐昔洛韦片，局部湿敷、尖锐湿疣皮损局部电凝等治疗，效果显著。     

芽生菌病样脓皮病

报告1例芽生菌病样脓皮病.患者女,62岁.而部皮肤出现结节、溃疡3个月余.皮肤科检查:双侧颊部、额部、鼻部有结节和疣状增殖性斑块,边缘隆起,表面旱菜花样,有脓性分泌物及结痂,双眼睑水肿.皮损组织病理检查示假上皮瘤样增生,真皮和增生的表皮内有多发性脓肿,主要成分为中性粒细胞,部分脓肿内可见多数嗜酸性粒细胞.脓性分泌物细菌培养见金黄色葡萄球菌生长.最终诊断:芽生菌病样脓皮病.     

浅表性大疱型坏疽性脓皮病

报告1例浅表性大疱型坏疽性脓皮病。患者女,58岁。四肢红斑、水疱、溃疡伴疼痛9d入院。组织病理表现为表皮内有一大脓疱,脓疱两侧表皮内有较多中性粒细胞侵入,两侧表皮有明显细胞间及细胞内水肿,真皮浅层及中层有弥漫性中性粒细胞浸润,有明显核尘,核碎裂,真皮胶原纤维间水肿,皮下组织有部分区域出血。类似于典型坏疽性脓皮病,但是在真皮中的位置更表浅。给予小剂量糖皮质激素,米诺环素,雷公藤多苷治疗,2个月后痊愈。     

Superficial granulomatous pyoderma: a case report of two Japanese patients and clinical comparison with foreign patients

Superficial granulomatous pyoderma (SGP) is an unusual variant type of pyoderma gangrenosum characterized by a benign course and specific histological features; it is quite a rare cutaneous disorder in Japan. We reported two Japanese cases of SGP and compared the clinical features of 13 Japanese cases with those of 42 foreign cases. Case 1 was a 53-year-old female who presented with three indolent and ulcerative plaques with elevated edges on the back and the posterior portion of the left thigh. Case 2 was a 74-year-old female who presented with crusted and vegetative erythematous plaques on the left shoulder and left upper arm. Histological examinations revealed a characteristic three-layer granuloma in each case. Laboratory and physical examinations found no abnormalities. Topical corticosteroid, oral administration of minocycline, and/or additional supplementation with corticosteroid were effective. In comparison with foreign cases, Japanese cases show a possible differentiation in the ratio of sex and distribution of the ulcer. Females have a high incidence and the extremities are frequently involved area in Japanese cases. Up to now, 11 cases of SGP have been reported in Japan. To our best knowledge, our patients are the first Japanese cases described in the English literature.     

混合细菌感染引起的芽生菌病样脓皮病1例

报告一例４７岁男怀芽生菌病样脓皮病，该例存在２两种细菌混合感染。经抗菌治疗等综合处理，大部分皮损愈合，留小片上损未愈，行刮除术后痊愈。     

Paraneoplastic vasculitis associated with multiple myeloma

The association between vasculitis and cancer has been widely reviewed in recent decades. The existence of malignancies in patients with vasculitis has been estimated at about 4.5-8%, haematological neoplasms being the most frequently observed. The haematological malignancies most frequently described are lymphoproliferative diseases such as hairy cell leukaemia and lymphomas. On the contrary, the incidence of paraneoplastic vasculitis in patients with myeloma is low; up to now, we have found nine cases reported on this subject. We report the case of a 73-year-old woman who in 1 year showed three outbreaks of acutely painful, purpuric and ulceronecrotic lesions, localized on the lower extremities. Histopathological study demonstrated thrombosis in the arterioles and leucocytoclastic vasculitis. Complementary tests revealed the presence of multiple myeloma.     

Light chain multiple myeloma with cutaneous AL amyloidosis

Cutaneous AL amyloidosis is one complication of multiple myeloma. In our patient, painful sclerotic skin changes on the extremities and macroglossia were the presenting features which led to a more detailed investigation and the diagnosis of multiple myeloma. Histological examination revealed cutaneous deposits of amyloid which were positive with Congo red stain and had an apple green color in polarized light.     

Two cases of pyoderma gangrenosum complicated with nasal septal perforation

We report two patients with pyoderma gangrenosum complicated with nasal septal perforation. An 18-year-old woman and a 65-year-old man had typical lesions of pyoderma gangrenosum on the legs that responded well to oral prednisolone. Both patients complained of mild nasal discharge, and nasal fibroscopy revealed nasal septal perforation. Biopsy of the nasal lesions showed an active inflammatory infiltrate, mainly of neutrophils. Systemic investigations failed to show any pulmonary or renal lesions of Wegener's granulomatosis. Cytoplasmic immunofluorescent pattern antineutrophil cytoplasmic antibody was negative. In both cases, intense neutrophilic infiltration was observed not only in skin lesions but also in nasal lesions, which may indicate that the nasal lesions had a pathogenesis in common with the skin lesions.