Archives of dermatology最新文献

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Total Skin Electron Irradiation (TSEI) May Induce Systemic Progression of Mycosis Fungoides (MF) - Cutaneous T-Cell Lymphoma (CTCL) 全皮肤电子照射(TSEI)可诱导蕈样真菌病(MF) -皮肤t细胞淋巴瘤(CTCL)的全身进展

Archives of dermatology

Pub Date : 2018-11-19 DOI: 10.36959/661/301

Shaaban Sherif G, Khan Mohammed K, Savage Natasha, Yan Weisi, Pishgou Mahboubeh, Davis Loretta, Mourad Waleed F

The management of MF-CTCL is based on a 'stage-based' approach and an evaluation by a multidisciplinary team is preferred. Initial treatment in patients with local (patch/plaque) disease includes skin-directed therapies (localized or generalized), with the addition of systemic biologic therapy for refractory, or progressive disease. In patients with unfavorable prognostic features (e.g., folliculotropic or large-cell transformed MF, or B1 involvement) systemic biologic therapies may be introduced earlier in the treatment algorithm.

引用次数: 1

Cutaneous Metastatic Renal Cell Carcinoma to the Skin Presenting as a Zosteriform Eruption 皮肤转移性肾细胞癌的皮肤表现为带状虫状疹

Archives of dermatology

Pub Date : 2018-08-15 DOI: 10.36959/661/300

H. Menon, R. Bernert, K. Jared, Burrell Wolk, Neil F. Fernandes

Cutaneous metastasis of internal malignancy is an uncommon but not rare phenomenon. Renal cell carcinoma is a visceral malignancy that rarely metastasizes to the skin and typically presents as a solitary red, purple nodule when it does. We describe a case of metastatic renal cell carcinoma to the skin presenting as a zosteriform eruption.

内部恶性肿瘤的皮肤转移是一种不常见但并不罕见的现象。肾细胞癌是一种内脏恶性肿瘤，很少转移到皮肤，通常表现为孤立的红、紫色结节。我们描述一个病例转移肾细胞癌的皮肤表现为带状虫状喷发。

引用次数: 0

Excellent Response to Hydroxychloroquine in a Young Man with Lupus Erythematosus Panniculitis 羟氯喹治疗青年人红斑狼疮泛膜炎疗效显著

Archives of dermatology

Pub Date : 2018-07-05 DOI: 10.36959/661/298

Parigini Aníbal María, Diego María Clara de, Beguerie Julieta Ruiz, Paredes Victoria Duran, A. Javier

Lupus erythematosus panniculitis is a rare variant of lupus erythematosus. We present the case of a young man with ulcerative colitis treated with mesalazine and a history of recurrent painful and indurated lesions on his face. A diagnosis of lupus profundus was made taking in account the clinical manifestations and the histological and immunofluorescence findings.

引用次数: 0

Quality of Life in Women with Alopecia 脱发妇女的生活质量

Archives of dermatology

Pub Date : 2018-07-05 DOI: 10.36959/661/299

Dawes Danyelle

Hair loss is a psychologically devastating disorder, causing grave distress to patients of all ages, genders, and nationalities. Due to the visible nature of hair loss, individuals become increasingly self-conscious, and over time may develop anxiety or depression [1]. Furthermore, the psychological stress related to alopecia can impair functioning in social and professional arenas, affecting relationships and creating work related problems [1]. Despite the available treatments for alopecia, their efficacy is not well established and following disease course and treatment success relies on patient perception [2]. Quality of life (QoL) studies are a valuable tool in assessing patient well-being, coping mechanisms, and disease burden on patients’ activities of daily living, as well as effects of therapy [2,3].

脱发是一种心理上毁灭性的疾病，对所有年龄、性别和国籍的患者都造成了严重的痛苦。由于脱发的可见性，个体变得越来越自我意识，随着时间的推移可能会产生焦虑或抑郁[1]。此外，与脱发相关的心理压力会损害社交和专业领域的功能，影响人际关系并产生与工作相关的问题[1]。尽管已有治疗脱发的方法，但其疗效尚不明确，后续病程和治疗成功与否取决于患者的感知[2]。生活质量(QoL)研究是评估患者幸福感、应对机制、疾病对患者日常生活活动的负担以及治疗效果的重要工具[2,3]。

引用次数: 0

Successful Long-term Use of Oral Isotretinoin for the Management of Morbihan Disease: A Case Series Report and Review of the Literature. 成功长期口服异维甲酸治疗莫比罕病:病例系列报告及文献回顾

Archives of dermatology

Pub Date : 2012-12-01 DOI: 10.1001/archdermatol.2012.3109

Lauren A Smith, David E Cohen

BACKGROUND Morbihan disease (MD) is characterized by persistent erythema and solid edema of the upper two-thirds of the face. It is generally regarded as a late-stage complication of rosacea, although its etiology is poorly understood. The standard therapeutic management includes systemic anti-inflammatory medications; however, the clinical response, if any, is often unsatisfactory. We review the current challenges and a promising new option for the treatment of MD. OBSERVATIONS Five cases of MD were treated with long-term (>6 months; mean, 16 months) oral isotretinoin, with documented nonrecurrence. The mean sustained daily dose was 60 mg/d (range, 40-80 mg/d), and the mean cumulative dose was approximately 285 mg/kg (range, 170-491 mg/kg). The total treatment period ranged from 10 to 24 months, with a mean disease-free follow-up period of 9 months (range, 1-24 months). A substantial clinical improvement was not noted until 6 months of treatment in all 5 cases. CONCLUSIONS We report 5 cases of MD that were successfully treated with long-term oral isotretinoin, with lasting results. Further research is required to better understand the pathogenesis of MD and isotretinoin's mechanism of action in this condition.

背景:莫比罕病(MD)的特征是面部上三分之二的持续红斑和实性水肿。它通常被认为是酒渣鼻的晚期并发症，尽管其病因尚不清楚。标准的治疗管理包括全身消炎药;然而，临床反应，如果有的话，往往是不令人满意的。我们回顾了目前的挑战和治疗MD的一个有希望的新选择。观察5例MD接受长期治疗(>6个月;平均16个月)口服异维甲酸，无复发记录。平均持续日剂量为60 mg/d(范围40-80 mg/d)，平均累积剂量约为285 mg/kg(范围170-491 mg/kg)。总治疗期10 ~ 24个月，平均无病随访9个月(1 ~ 24个月)。所有5例患者在治疗6个月后才出现明显的临床改善。结论:我们报告了5例长期口服异维甲酸治疗MD的成功病例，并取得了持久的效果。需要进一步的研究来更好地了解MD的发病机制和异维甲酸在这种情况下的作用机制。

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引用次数: 38

Top-Accessed Article: Successful Treatment of Vitiligo With 0.1% Tacrolimus Ointment 顶级访问文章:0.1%他克莫司软膏成功治疗白癜风

Archives of dermatology

Pub Date : 2012-12-01 DOI: 10.1001/ARCHDERMATOL.2012.2385

R. Halder, Ife J. Rodney

1. Lipsker D, Rondeau M, Massard G, Grosshans E. The AESOP (adenopathy and extensive skin patch overlying a plasmacytoma) syndrome: report of 4 cases of a new syndrome revealing POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes) syndrome at a curable stage. Medicine (Baltimore). 2003;82(1):51-59. 2. Gupta RM, Roy DC, Gupta IM, Khanna S. Extramedullary plasmacytoma IgG type I presenting as mediastinal syndrome. Br J Dis Chest. 1974;68(1):65-70. 3. Read D, Warlow C. Peripheral neuropathy and solitary plasmacytoma. J Neurol Neurosurg Psychiatry. 1978;41(2):177-184. 4. Feddersen RM, Burgdorf W, Foucar K, Elias L, Smith SM. Plasma cell dyscrasia: a case of POEMS syndrome with a unique dermatologic presentation. J Am Acad Dermatol. 1989;21(5, pt 2):1061-1068. 5. Weichenthal M, Stemm AV, Ramsauer J, Mensing H, Feller AC, Meigel W. POEMS syndrome: cicatricial alopecia as an unusual cutaneous manifestation associated with an underlying plasmacytoma. J Am Acad Dermatol. 1999; 40(5, pt 2):808-812.

1. Lipsker D, Rondeau M, Massard G, Grosshans E. AESOP(腺病和广泛的皮肤斑块覆盖浆细胞瘤)综合征:报告4例新的综合征，显示POEMS(多神经病变，器官肿大，内分泌病变，单克隆蛋白和皮肤变化)综合征处于可治愈阶段。医学(巴尔的摩)。2003年,82(1):51-59。2. 古普塔RM, Roy DC，古普塔IM, Khanna S.髓外浆细胞瘤IgG型表现为纵隔综合征。[J]中华疾病杂志，2004;32(1):1 -7。3.Read D, Warlow c。周围神经病变和孤立性浆细胞瘤。中华神经外科杂志。1998;31(2):387 - 398。4. Feddersen RM, Burgdorf W, Foucar K, Elias L, Smith SM。浆细胞病变:POEMS综合征1例，具有独特的皮肤病学表现。中华皮肤科杂志，2009;21(5):1061-1068。5. 魏建峰，张建军，张建军，张建军，张建军，张建军，张建军，张建军，张建军，张建军。中华皮肤科杂志。1999;40(5):808-812。

引用次数: 0

Acrally distributed purpuric and necrotic lesions with pustular features. 呈脓疱状分布的紫癜性和坏死性病变。

Archives of dermatology

Pub Date : 2012-12-01 DOI: 10.1001/archderm.148.12.1411-b

Maya Barsky, H William Higgins, Kachiu C Lee, Leslie Robinson-Bostom, Jennie J Muglia

A 27-year-old woman with a painful, reddish-blue (livedoid) skin area showing small ulcerations on the lower abdomen (Figure 1) was examined. The lesion appeared a few centimeters above the inconspicuous, vertically oriented scar 4 weeks after a cesarean section. A regimen of systemic antibiotics had not been successful. Her medical records revealed a problem with excess weight (body mass index 40 [calculated as weight in kilograms divided by height in meters squared]) and a smoking habit. Laboratory test findings were unrevealing, except for increased antinuclear antibody level (1:160) and a slightly elevated parathyroid hormone level (calcium, phosphate, and vitamin D were within normal levels), which both returned to normal within 6 months. Prothrombotic factors (cryoglobulins and anticardiolipin antibodies) were negative. A biopsy was obtained from a central, nonulcerated region and analyzed with hematoxylin-eosin and CD31 staining (Figure 2 and Figure 3). What is your diagnosis?

引用次数: 1

Grouped erythematous papules and nodules on the thigh. 大腿上有成组的红斑丘疹和结节。

Archives of dermatology

Pub Date : 2012-12-01 DOI: 10.1001/archderm.148.12.1411-c

Julia M Kwan, Elizabeth K Satter

引用次数: 0

Dermoscopy of squamous cell carcinoma and keratoacanthoma. 鳞状细胞癌和角棘瘤的皮肤镜检查。

Archives of dermatology

Pub Date : 2012-12-01 DOI: 10.1001/archdermatol.2012.2974

Cliff Rosendahl, Alan Cameron, Giuseppe Argenziano, Iris Zalaudek, Philipp Tschandl, Harald Kittler

OBJECTIVES To characterize dermoscopic criteria of squamous cell carcinoma (SCC) and keratoacanthoma and to compare them with other lesions. DESIGN Observer-masked study of consecutive lesions performed from March 1 through December 31, 2011. SETTING Primary care skin cancer practice in Brisbane, Australia. PARTICIPANTS A total of 186 patients with 206 lesions. MAIN OUTCOME MEASURES Sensitivity, specificity, predictive values, and odds ratios. RESULTS In a retrospective analysis of 60 invasive SCC and 43 keratoacanthoma cases, keratin, surface scale, blood spots, white structureless zones, white circles, and coiled vessels were commonly found in both types of lesions. We reevaluated the significance of these criteria in 206 raised, nonpigmented lesions (32 SCCs, 29 keratoacanthomas, and 145 other lesions). Central keratin was more common in keratoacanthoma than in SCC (51.2% vs 30.0%, P = .03). Keratin had the highest sensitivity for keratoacanthoma and SCC (79%), and white circles had the highest specificity (87%). When keratoacanthoma and SCC were contrasted with basal cell carcinoma, the positive predictive values of keratin and white circles were 92% and 89%, respectively. When SCC and keratoacanthoma were contrasted with actinic keratosis and Bowen disease, the positive predictive value of keratin was 50% and that of white circles was 92%. In a multivariate model, white circles, keratin, and blood spots were independent predictors of SCC and keratoacanthoma. White circles had the highest odds ratio in favor of SCC and keratoacanthoma. The interobserver agreement for white circles was good (0.55; 95% CI, 0.44-0.65). CONCLUSIONS White circles, keratin, and blood spots are useful clues to differentiate SCC and keratoacanthoma from other raised nonpigmented skin lesions by dermoscopy. The significance of these criteria depends on the clinical context.

目的探讨鳞状细胞癌(SCC)和角棘瘤的皮肤镜诊断标准，并与其他病变进行比较。设计:对2011年3月1日至12月31日的连续病变进行观察者屏蔽研究。背景:澳大利亚布里斯班的初级保健皮肤癌诊所。参与者共186名患者，206个病变。主要结局指标敏感性、特异性、预测值和优势比。结果回顾性分析60例浸润性鳞状细胞癌和43例角棘瘤，两种病变均可见角蛋白、表面鳞片、血斑、白色无结构区、白色圆圈和卷曲血管。我们重新评估了这些标准在206个凸起的非色素病变中的意义(32个SCCs, 29个角棘层瘤和145个其他病变)。中心角蛋白在角棘瘤中比在鳞状细胞癌中更常见(51.2% vs 30.0%， P = 0.03)。角蛋白对角棘瘤和鳞状细胞癌的敏感性最高(79%)，白色圆圈的特异性最高(87%)。当角棘瘤和鳞状细胞癌与基底细胞癌对比时，角蛋白和白色圆圈的阳性预测值分别为92%和89%。当SCC和角棘瘤与光化性角化病和Bowen病对比时，角蛋白阳性预测值为50%，白圈阳性预测值为92%。在一个多变量模型中，白色圆圈、角蛋白和血斑是SCC和角棘瘤的独立预测因子。白色圆圈有利于SCC和角棘瘤的比值比最高。观察者间对白圈的一致性很好(0.55;95% ci, 0.44-0.65)。结论皮肤镜下，白色圆圈、角蛋白和血斑是鉴别鳞状细胞癌和角棘瘤与其他凸起的非色素皮肤病变的有用线索。这些标准的意义取决于临床情况。

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引用次数: 137

Circumscribed acral hypokeratosis: successful treatment of a potentially premalignant condition. 局限性肢端角化不足:成功治疗潜在的恶性前病变。

Archives of dermatology

Pub Date : 2012-12-01 DOI: 10.1001/archdermatol.2012.2919

Lara K Butler, Elizabeth A Kiracofe, Victor J Marks

C ircumscribed acral hypokeratosis (CAH) is a rare benign dermatosis of unknown origin first described in 2002. This uncommon dermatosis is seen predominantly on the palms of adult women with a mean age of 65 years. Lesions have a predilection for the thenar or hypothenar eminence of the predominant palm and less frequently on the soles. Typically, the lesions are solitary, but multiple lesions have been reported. Circumscribed acral hypokeratosis has characteristic clinicopathologic features and runs a chronic course. Histologically, the lesions show a classic abrupt decrease in the thickness of the stratum corneum, forming a sharp stair between normal and involved acral skin. The lack of epidermal atypia or cornoid lamellae clearly differentiates CAH from its clinical mimics, Bowen disease and porokeratosis. Circumscribed acral hypokeratosis is generally considered a benign condition, but Kanitakis et al recently reported a case of CAH that underwent premalignant transformation and hypothesized that the absence of the horny layer rendered the underlying keratinocytes susceptible to photocarcinogenesis. This report emphasized the need for close follow-up and suggested that treatment of CAH lesions may be useful to prevent malignant transformation. We describe herein a patient who experienced a sustained complete clinical response after treatment with liquid nitrogen cryotherapy.

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引用次数: 7

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