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Unilateral Nevoid Hyperkeratosis of the Nipple and Areola Treated Successfully With Carbon Dioxide Laser 二氧化碳激光成功治疗单侧乳头乳晕空洞性角化过度症
Pub Date : 2016-12-05 DOI: 10.19070/2332-2977-SI01001
E. S, Lahlou A, Salim G, B. H, Rimani M
Nevoid hyperkeratosis of the nipple and areola (NHNA), first described by Tauber [1] in 1923, is a rare benign condition with fewer than 70 cases reported in the literature. Nevoid hyperkeratosis presents as asymptomatic and hyperpigmented filiform or papular warty excrescences on the nipple, the areola or both. NHNA is commonly bilateral, and appear in women in their second or third decade, at puberty or during pregnancy [2], suggesting the role of hormone in its pathogenesis [1].
乳头乳晕Nevoid hyperkeratosis of nipple and areola (NHNA),由Tauber[1]于1923年首次描述,是一种罕见的良性疾病,文献报道的病例不到70例。乳突角化过度症表现为无症状和色素沉着的丝状或丘疹状疣状赘生物,在乳头,乳晕或两者。NHNA通常是双侧的,出现在20岁或30岁的女性、青春期或怀孕期间[2],提示激素在其发病机制中的作用[1]。
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引用次数: 1
Oral Health Issues in Psoriasis: An Overview of the Literature 牛皮癣的口腔健康问题:文献综述
Pub Date : 2016-11-19 DOI: 10.19070/2332-2977-1600025
Monson Ca, Silva V, Porfírio G, Riera R, Tweed Ja
Psoriasis is defined as an immune-mediated multiple-cause disease of genetic basis [1] and different phenotypes [2] that affects up to 8.5% of the population in the Western countries and requires careful management [3]. Among the skin chronic forms of psoriasis, those with circumscribed thick white to silver plaques, surrounded by areas redness are more common [4]. Psoriasis can spread to the elbows, knees, shins, scalp, lower back, nails, genitals, mouth and joint areas with many grades of damage, leading to the emotional consequences with negative impact in the patient’s life [3, 6]. Oral cavity can reveals details about systemic health status. Oral diseases also have immune-involvement with multiple causes and can lead to local and systemic complications. Oral care are the health treatments that people more often have performed [74]. Relying on surgical resources and increasingly advanced pharmacological therapy, these treatments can lead to the damages, even in healthy patients [4]. In some conditions, dental treatments can be invasive and for Psoriasis it can cause problems in complex ways. The oral aspects for psoriasis were not assessed with a comprehensive literature review and accurate inferences are possible only if a previous systematic analysis of risk factors was done [5].
牛皮癣被定义为一种具有遗传基础[1]和不同表型[2]的免疫介导的多因疾病,在西方国家影响高达8.5%的人群,需要谨慎治疗[3]。在皮肤慢性型牛皮癣中,伴有有边界的白色至银色厚斑,周围有红色区域的牛皮癣更为常见[4]。银屑病可扩散到肘部、膝盖、胫骨、头皮、下背部、指甲、生殖器、口腔和关节等部位,损伤程度不一,导致情绪后果,对患者的生活产生负面影响[3,6]。口腔可以揭示全身健康状况的细节。口腔疾病也有多种原因的免疫参与,并可导致局部和全身并发症。口腔护理是人们经常进行的健康治疗[74]。依靠手术资源和日益先进的药物治疗,即使在健康患者中,这些治疗也可能导致损害[4]。在某些情况下,牙科治疗可能是侵入性的,对于牛皮癣来说,它可能会以复杂的方式引起问题。牛皮癣的口腔方面没有经过全面的文献回顾评估,只有在之前对危险因素进行系统分析后才能得出准确的推断[5]。
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引用次数: 7
Paraneoplastic Dermatomyositis: About 9 Patients 副瘤性皮肌炎:约9例
Pub Date : 2016-10-30 DOI: 10.19070/2332-2977-1600023
A. Lahlou, S. Elloudi, H. Baybay, F. Mernissi
Dermatomyositis, a rare inflammatory disease possibly of autoimmune origin, produces a characteristic skin rash and sym - metrical proximal myopathy. Patients with Dermatomyositis have a higher incidence rate of cancer, compared with the general population, since DM usually presents as a paraneoplastic syndrome. through the study of 9 cases of paraneoplastic dermato- myositis we will discuss the clinical feature, paraclinical, etiological, therapeutic and outcomes of paraneoplastic dermatomy- ositis (PDM) relative to the literature.
摘要皮肌炎是一种罕见的炎症性疾病,可能由自身免疫性引起,可产生特征性皮疹和对称性近端肌病。与一般人群相比,皮肌炎患者有更高的癌症发病率,因为糖尿病通常表现为副肿瘤综合征。本文通过对9例副瘤性皮肌炎的研究,结合文献讨论副瘤性皮肌炎的临床特点、临床旁、病因、治疗及预后。
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引用次数: 0
Primary Cutaneous Large B Cell Lymphoma, Leg Type: Good Evolution of A Particular Location 原发性皮肤大B细胞淋巴瘤,腿部型:特定部位的良好进化
Pub Date : 2016-10-06 DOI: 10.19070/2332-2977-1600024
Lahlou A, E. S, B. H, Mernissi Fz
Primary cutaneous B-cell lymphomas are a heterogeneous group of rare clonal B-cell lymphoproliferative disorders with distinct clinicopathological features compared with nodal counterparts [1]. Primary cutaneous diffuse large B-cell lymphoma-leg type (PCLBCL-LT) is a rare subtype which constitutes only 4% [2]. They have a predilection to the leg (72%), advanced age of onset (mean age, 76 years), high Bcl-2 expression (85%) and frequent relapses with extracutaneous dissemination [10-20%]. We report a case we report the case of a young patient of 39 years old who consulted for a hummocky tumor in the back whose histology was in favor of lymphoma B-type leg, with good response to rituximab combined with doxorubicin, cyclophosphamide, vincristine, and prednison (R-CHOP).
原发性皮肤b细胞淋巴瘤是一种异质性的罕见克隆性b细胞淋巴增生性疾病,与淋巴结性b细胞淋巴瘤相比,具有不同的临床病理特征[1]。原发性皮肤弥漫性大b细胞淋巴瘤腿部型(PCLBCL-LT)是一种罕见的亚型,仅占4%[2]。他们倾向于腿部(72%),发病年龄较晚(平均年龄76岁),Bcl-2高表达(85%),经常复发并皮外传播[10-20%]。我们报告一例39岁的年轻患者,因背部隆起性肿瘤就诊,其组织学倾向于b型腿部淋巴瘤,利妥昔单抗联合阿霉素、环磷酰胺、长春新碱和prednison (R-CHOP)疗效良好。
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引用次数: 0
Stevens - Johnson Syndrome Induced by Sorafenib for Hepatocellular Carcinoma 索拉非尼治疗肝细胞癌诱导的史蒂文斯-约翰逊综合征
Pub Date : 2016-05-09 DOI: 10.19070/2332-2977-160001
R. Chakiri, Z. Douhi, M. Meziane, Mernissi Fz
Dermatological examination had found: erythematous target lesion in the upper limbs and back (Figure 1), urticarial plaques on the trunk, purpuric lesions on the lower extremities and blisters stretched at the back side of 2 feet and achieving of the buccal and genital mucosa (Figure 2). Admission laboratory tests revealed several abnormal finding: hypereosinophilia in 2100 element/mm3 and hepatic cytolysis (SGOT=92 UI/L→2xN, SGPT=188 UI/L→4xN).
皮肤检查发现:上肢及背部红斑靶病变(图1),躯干荨麻疹斑块,下肢紫癜性病变,2尺后侧延伸水疱,达到颊粘膜及生殖器粘膜(图2)。入院实验室检查发现多处异常:嗜酸性粒细胞增多2100 element/mm3,肝细胞溶解(SGOT=92 UI/L→2xN, SGPT=188 UI/L→4xN)。
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引用次数: 0
The Guardians of the Skin Immune System 皮肤免疫系统的守护者
Pub Date : 2016-04-20 DOI: 10.19070/2332-2977-160004e
Tapia Fj, Venezuela Ministerio de Salud, R. Ol
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引用次数: 0
Congenital Multiple Glomangiomas of the Breast Arranged in a Segmental Pattern 先天性乳腺多发性血管瘤呈节段性排列
Pub Date : 2015-12-02 DOI: 10.19070/2332-2977-1500020
P. Morais, L. Peralta, H. Bettencourt, A. Mota
An otherwise healthy 15-year-old female patient presented with multiple bluish skin papules and nodules located at right breast that had been present since birth. The lesions were slightly tender to palpation and had enlarged with body growth, especially after menarche. Her father presented several lesions with a similar appearance on the upper limbs and trunk. On physical examination, multiple soft, well-defined dark-blue and purple-red papules and nodules were observed, arranged in a segmental or band-like pattern, in the girl’s right breast and ipsilateral axilla (Figure 1a). Dermoscopy of lesions revealed reddish purple structureless areas, without specific features of any skin neoplasm (Figure 1b). A biopsy of a breast nodule was performed. The histological examination revealed a non encapsulated vascular tumor involving the mid and lower dermis. It was composed of multiple dilated, cavernous-like capillaries containing erythrocytes surrounded by endothelial cells, and one to several layers of uniform cuboidal cells with pale or faintly eosinophilic cytoplasm (glomus cells) (Figure 1c). These features were consistent with the diagnosis of glomangioma. Complete blood and platelet counts, coagulation tests and fecal occult blood test were within normal range. Informed about the nature of the lesions and treatment options the patient chose therapeutic abstention.
一位健康的15岁女性患者,自出生以来右乳出现多发蓝色皮肤丘疹和结节。病变触诊轻微,随身体生长而增大,特别是在月经初潮后。她父亲的上肢和躯干出现了几处类似的病变。体格检查,女孩右乳及同侧腋窝可见多发软质、界限分明的深蓝色和紫红色丘疹和结节,呈节段或带状排列(图1a)。皮损镜显示为红紫色无结构区,无任何皮肤肿瘤的特异性特征(图1b)。对乳腺结节进行活组织检查。组织学检查显示一非包膜血管性肿瘤累及真皮中下部。它由多个扩张的海绵状毛细血管组成,毛细血管中含有被内皮细胞包围的红细胞,以及一到几层均匀的立方体细胞,细胞质苍白或略带嗜酸性(球囊细胞)(图1c)。这些特征与血管瘤的诊断一致。全血和血小板计数、凝血试验和粪便潜血试验均在正常范围内。在得知病变的性质和治疗方案后,患者选择了治疗性戒酒。
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引用次数: 0
Rapid Recovery from Skin Warts by Explicit Homeopathic Medicines 通过明确的顺势疗法药物快速恢复皮肤疣
Pub Date : 2015-11-13 DOI: 10.19070/2332-2977-1500019
S. Swami, Pradhan Ak
Human papillomaviruses (HPVs) under the Papillomavirus family are common agents for producing skin warts in adults; as well as in children, throughout the globe. Although the frequency is unknown, warts are estimated to affect approximately 7-12% of the population. In school-aged children, the prevalence is 10-20%. An increased frequency also is seen among immunosuppressed patients and meat handlers. It is now well known that various HPV types are acquired in early infancy [1] and they persist for a pretty long time in the skin as observed by many scientists-even up to more than 60 years [2-4], and parental sharing of these viruses has also been noted [2, 4], although horizontal transmission from other persons is also an important way to spread this disease [4]. There are more than 200 types, of which 100 has been sequenced. Distinct histopathological types are also attributed to different skin HPVs particularly types 1, 2, 3, 4, 27 and 57 [5]. Verruca vulgaris is the commonest wart, although other types like planter and flat warts are not uncommon. Warts are usually highly prevalent in lower age groups and then gradually decrease with age [6], with no sex preponderance [7]. In a Taiwan study hand warts were found in 2.8 per cent of school children [8]. Warts or Verrucae are of different clinical types, depending on the morphology of the warts, the site affected and the mode of transmission. HPVs affect human skin and the moist membranes such as the throat, mouth, feet, fingers, nails, anus and cervix. It is a self limiting disease and in most of the cases spontaneous resolution takes place within 2yrs. The primary clinical manifestations of HPV infection include common warts, genital warts, flat warts, and deep palmoplantar warts. Most known HPV types cause no symptoms to humans but they may cause cosmetic disfigurement or tenderness. Plantar warts can be painful, and extensive involvement on the sole of the foot may impair ambulation. A small number can increase the risk of cancers specially if the lesion persists for a long time in cervix and vagina, penis, anus and oropharynx (HPV 16 and 18 strains). The CDC observed that over 70 percent of infections in young females clear up within 12 months, while 90% do so within 24 months. There are 40 types of HPVs which are transmitted sexually, affecting ano-genital areas, the other types are transmitted by personal contact or indirect transmission from using untreated swimming pool, fomites etc. or by auto-inoculation. Persistent long-term HPV infection raises the risk of developing precancerous lesions of the cervix and other region. However, in the majority of cases, cancer can be prevented. Among different types, types 16, 18, 33, 35, 45, 51, 52, 56, 58, 59, 68, 73, and 82 can cause cancer they are carcinogenic and are sexually transmitted. The HPV virus enters the human body through a small cut, tear, or abrasion on the epidermis; the primary mode of transmission is through skin-to-skin contact.
人乳头瘤病毒(hpv)属于乳头瘤病毒家族,是成人皮肤疣的常见病原体;全球的儿童也是如此。虽然发病率未知,但估计约有7-12%的人患疣。在学龄儿童中,患病率为10-20%。在免疫抑制的病人和肉类加工者中,发病率也有所增加。现在众所周知,各种类型的HPV是在婴儿早期获得的[1],许多科学家观察到它们在皮肤中持续相当长的时间-甚至超过60年[2-4],父母共享这些病毒也被注意到[2,4],尽管其他人的水平传播也是传播这种疾病的重要途径[4]。有200多种,其中100种已被测序。不同的皮肤hpv也有不同的组织病理类型,特别是1、2、3、4、27和57型[5]。寻常疣是最常见的疣,尽管其他类型如种植疣和扁平疣并不罕见。疣通常在低龄人群中高发,然后随着年龄的增长逐渐减少[6],无性别优势[7]。台湾的一项研究发现,2.8%的学龄儿童患有手疣[8]。疣或疣有不同的临床类型,取决于疣的形态、受影响的部位和传播方式。人乳头瘤病毒感染人体皮肤和湿润膜,如喉咙、嘴、脚、手指、指甲、肛门和子宫颈。这是一种自限性疾病,大多数病例在2年内自行消退。HPV感染的主要临床表现包括普通疣、生殖器疣、扁平疣和深掌足底疣。大多数已知的HPV类型对人类没有症状,但它们可能导致美容毁容或压痛。足底疣可以是痛苦的,并广泛涉及到脚底可能损害行动。少量会增加患癌症的风险,特别是如果病变在子宫颈、阴道、阴茎、肛门和口咽部持续很长时间(HPV 16和18株)。美国疾病控制与预防中心观察到,在年轻女性中,超过70%的感染在12个月内消失,而90%的感染在24个月内消失。有40种人乳头状瘤病毒是通过性行为传播的,影响非生殖器区域,其他类型是通过个人接触或使用未经处理的游泳池、污染物等间接传播或通过自身接种传播的。持续长期的HPV感染会增加子宫颈和其他区域发生癌前病变的风险。然而,在大多数情况下,癌症是可以预防的。在不同的类型中,16型、18型、33型、35型、45型、51型、52型、56型、58型、59型、68型、73型和82型可以致癌,它们是致癌的,是性传播的。HPV病毒通过表皮上的小切口、撕裂或磨损进入人体;主要传播方式是通过皮肤接触。在我们的诊所,我们首先对45名患者进行了初步研究,然后计划对100名皮肤HPV感染患者进行主研究,这些患者使用顺势疗法药物治疗,以及10例仅使用含有原始药物载体的安慰剂治疗的对照组。我们的研究结果的细节将在以下章节中给出。
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引用次数: 5
Chronic Cutaneous Blastomycosis 慢性皮肤芽生菌病
Pub Date : 2015-10-12 DOI: 10.19070/2332-2977-1500018
R. Gandhi, C. Ulman, K. Kellawan, T. Olsen, J. Trevino, S. Krishnamurthy
A 71 year-old male veterinarian developed swelling and an erythematous eruption on his right 4th finger two weeks after receiving a puncture wound from the claw of a cat. The patient denied pain, pruritus, or ulceration, and review of systems was negative. Four weeks later, the patient developed tender right epicondylar lymphadenopathy. His primary care physician treated him empirically with multiple antibiotics including amoxicillin/clavulanic acid, doxycycline, and rifampin. His lymphadenopathy resolved; however, the rash persisted.
一名71岁男性兽医在被猫爪刺伤两周后,右手无名指出现肿胀和红斑疹。患者否认有疼痛、瘙痒或溃疡,系统检查阴性。四周后,患者出现压痛性右上髁淋巴结病。他的初级保健医生经验性地用多种抗生素治疗他,包括阿莫西林/克拉维酸、强力霉素和利福平。他的淋巴结病消失了;然而,皮疹持续存在。
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引用次数: 0
Toward a Melanoma Dendritic Cell Vaccine using Neoantigens 利用新抗原研制黑色素瘤树突状细胞疫苗
Pub Date : 2015-09-28 DOI: 10.19070/2332-2977-150003e
Tapia Fj
Dendritic cells are the first and only cells capable of inducing a primary immune response activating resting naïve T cells in secondary lymphoid tissues (ie. lymph nodes) from antigens that they capture in the epithelia. Dendritic cells are called immature when they are in the epithelium functioning as phagocytes, and mature when they act as antigen-presenting cells in the lymph nodes. In the study, the inoculation of dendritic cells pulsed with neoantigens produced a robust immune response in three adult patients with advanced cutaneous melanoma. These melanomas were IIIC, resected and had not responded to prior therapy with anti-CTLA-4 (Ipilimumab), which stimulates the proliferation and activation of T cells that facilitate the destruction of tumor cells.
树突状细胞是第一个也是唯一一个能够诱导初级免疫反应的细胞,可以激活次级淋巴组织中静止的naïve T细胞。淋巴结)从它们在上皮细胞中捕获的抗原。当树突状细胞在上皮中充当吞噬细胞时被称为未成熟细胞,当它们在淋巴结中充当抗原呈递细胞时被称为成熟细胞。在这项研究中,树突状细胞与新抗原的脉冲接种在三个成年晚期皮肤黑色素瘤患者中产生了强大的免疫反应。这些黑色素瘤是IIIC型的,切除了,并且对先前的抗ctla -4 (Ipilimumab)治疗没有反应,抗ctla -4刺激T细胞的增殖和激活,促进肿瘤细胞的破坏。
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引用次数: 0
期刊
Journal of Clinical Dermatology
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