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Objective:To summarize clinical manifestations and histopathological features of granular parakeratosis (GP) after exposure to benzalkonium chloride.Methods:A retrospective analysis was performed on 7 GP cases with a history of benzalkonium chloride exposure in the Department of Dermatology at Wuhan No.1 Hospital from April to August 2022. Data were collected on the general condition, skin lesion manifestations, pathological examination, treatment, and follow-up of the patients, and retrospectively analyzed.Results:The 7 adult patients with GP typically presented with erythema and brown scales in the intertriginous area, exhibiting an annular distribution pattern. All the 7 patients reported recent exposure to disinfectants containing benzalkonium chloride. A total of 10 skin biopsies were taken from the 7 patients. Histopathological examination showed characteristic hyperkeratosis and fine blue-gray parakeratotic granules in the stratum corneum. All skin lesions improved 1 month after cessation of exposure to benzalkonium chloride.Conclusion:GP has a distinct clinical pattern and histopathological manifestations, and a history of exposure to benzalkonium chloride can be helpful for the diagnosis of GP.
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Objective:To retrospectively analyze clinical characteristics and treatment of pemphigus/bullous pemphigoid (BP) complicated by herpes simplex virus (HSV) infection.Methods:Inpatients with pemphigus/BP complicated by HSV infection were collected from Wuhan No.1 Hospital from 2016 to 2021, and their clinical characteristics, treatment and follow-up results were retrospectively analyzed.Results:Among the 8 patients with pemphigus/BP complicated by HSV infection, there were 2 males and 6 females, and their age was 50.6 ± 8.3 years. Five of them were diagnosed with pemphigus vulgaris (PV), 1 with pemphigus foliaceus (PF), and 2 with BP. Seven were infected with HSV-1, and 1 with HSV-2. All the 8 patients were given systemic glucocorticoids and immunosuppressive agents for the treatment of pemphigus or BP, and were admitted to the hospital due to resistance to the treatment. Seven patients presented with exacerbation or recurrence of primary lesions, and 1 presented with enlarged lesions all over the body. HSV infection-induced lesions were located on the trunk in 4 cases, on the oral mucosa in 4, on the scalp in 3, and on the face in 2; lesions mainly manifested as irregular erosions with blood crusts, and some centrally umbilicated pustules; 7 patients had obvious pain at the lesional sites. During HSV infection, anti-desmoglein 1 antibody levels decreased in all the 6 patients with pemphigus, and anti-desmoglein 3 antibody levels decreased in 4 of the 5 patients with pemphigus vulgaris; anti-BP180 antibody levels decreased in 1 patient with BP, but increased in the other one with BP. After antiviral therapy at adequate doses for adequate durations (7- to 14-day treatment with valacyclovir alone or in combination with ganciclovir), HSV infection was controlled, the autoimmune bullous skin disorder intensity scores decreased compared with those before the antiviral therapy, and pain was significantly relieved in all the patients. No dose adjustment of glucocorticoids or other immunosuppressive agents was made during antiviral therapy in all patients.Conclusion:HSV infection should be considered when patients with pemphigus/BP suffer from recurrence or exacerbation and poorly respond to conventional treatment; for patients with pemphigus/BP complicated by HSV infection, systemic antiviral therapy at adequate doses can be used to control the disease condition without modifying the conventional immunosuppressive regimen.
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Objective:To investigate the efficacy of modified Mohs micrographic surgery in the treatment of eccrine porocarcinoma.Methods:Clinical data were collected from 5 patients with eccrine porocarcinoma, who treated with modified Mohs micrographic surgery in Department of Dermatology, Wuhan No.1 Hospital from 2016 to 2020, and retrospectively analyzed.Results:Among the 5 patients, 2 were males and 3 were females, their age ranged from 52 to 80 years, and the course of disease ranged from 1 to 50 years. Skin lesions were located on the scalp, face, abdomen, thighs and feet, with diameters ranging from 1 to 6 cm. Tumor excision was performed with 1-cm margins, and was deep to the superficial fascial layers. For histopathologically negative surgical margins, the defects were closed with skin flaps or grafts; for histopathologically positive margins, the excision margin continued to be widened until it was clean. The 5 patients were followed up for 1 - 5 years without recurrence, and 1 died 2 years later due to liver cancer metastasis.Conclusion:Modified Mohs micrographic surgery can ensure clean resection margins and reduce the loss of normal tissues in the treatment of eccrine porocarcinoma.
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A 58-year-old female patient presented with painful and itchy skin lesions on the head, neck, chest and back for 20 days, and was admitted to the hospital in February 2010. The skin lesions manifested as superficial erosions on an erythematous base with positive Nikolsky′s sign. Histopathological examination showed fissures above the granular and spinous cell layers, and scattered dyskeratotic cells. Direct immunofluorescence (DIF) assay revealed IgG and C3 deposits between spinous cells. The patient was initially diagnosed with pemphigus foliaceus. After the treatment with triamcinolone (24 mg/d) , tripterygium glycosides (60 mg/d) , nicotinamide (300 mg/d) and tetracycline (2 g/d) , skin lesions gradually subsided. In June 2017, the patient was readmitted due to itchy skin lesions on the head, neck, chest, back and hands for 15 days, which manifested as tense bullae on an erythematous base with negative Nikolsky′s sign. Histopathological examination showed subepidermal blisters and infiltration of eosinophils and lymphocytes in the blisters and superficial dermis, DIF assay revealed the deposition of IgG and C3 along the basement membrane zone, and enzyme-linked immunosorbent assay showed positive results for anti-BP180 antibody but negative results for anti-Dsg1 and Dsg3 antibodies. Then, a diagnosis of bullous pemphigoid was confirmed. The patient was treated with oral triamcinolone (12 mg/d) , nicotinamide (300 mg/d) and tetracycline (2 g/d) , and the lesions rapidly subsided.
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Objective:To preliminarily investigate dermoscopic characteristics of trichoblastoma, and to provide ideas for clinical diagnosis of trichoblastoma.Methods:Clinical data were collected from 5 patients with trichoblastoma who underwent both dermoscopic and histopathological examinations in Wuhan No.1 Hospital from November 2018 to July 2021, and dermoscopic features were analyzed retrospectively.Results:According to the presence or absence of pigments, trichoblastoma was divided into 2 subtypes: pigmented trichoblastoma (3 cases) and non-pigmented trichoblastoma (2 cases) . Dermoscopic examination of the 3 cases of pigmented trichoblastoma showed blue-gray ovoid nests (3 cases) , arborizing vessels (2 cases) , blue-gray globules (2 cases) , bright white structureless areas (2 cases) , concentric structures (1 case) and ulcers (1 case) ; no yellow-whitish homogenous structure was found. As for non-pigmented trichoblastoma, dermoscopic features included arborizing vessels (2 cases) , yellow-whitish homogenous structures (2 cases) , bright white structureless areas (2 cases) and blue-gray globules (1 case) ; no ulcers or blue-gray ovoid nests were observed in either case.Conclusion:Dermoscopic patterns differ between pigmented and non-pigmented trichoblastoma, so dermoscopy can provide preliminary diagnostic clues for trichoblastoma.
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Objective:To investigate epidemiological characteristics of outpatients and disease spectrum in the dermatology department during the COVID-19 epidemicMethods:A retrospective comparison of outpatient visits, gender, age and disease types in the dermatology department of Wuhan No.1 Hospital was performed between COVID-19 epidemic period (from 23th January 2020 to 15th April 2020) and the same period in 2019. Enumeration data were analyzed by Pearson′s chi-square test.Results:During the COVID-19 epidemic, the number of outpatient visits to the dermatology department of the hospital decreased markedly, and the average daily number of outpatient visits (236 visits/day) was only 8.81% of that during the same period in 2019 (2 678 visits/day) ; the ratio of male to female patients was reversed from 1∶1.37 in 2019 to 1.16∶1 in 2020; the proportions of patients aged 0-6, 7-12, 13-17 and 18-45 years significantly decreased compared with those in 2019 (all P < 0.001) , and the proportions of patients aged 46-69 and > 69 years significantly increased (both P < 0.001) . During the COVID-19 epidemic, there were 171 types of skin diseases in the dermatology outpatient department, and the number of disease categories decreased compared with that during the same period in 2019 (442 types) ; the number of patient visits for allergic skin diseases, erythematous papulosquamous skin diseases, viral infectious skin diseases and bacterial infectious skin diseases significantly increased compared with that during the same period in 2019 (all P < 0.001) , while the number of patient visits for sebaceous and sweat gland disorders, pigmented skin diseases and physical skin diseases significantly decreased (all P < 0.001) . Conclusion:Compared with the same period in 2019, the number of outpatient visits, patient sex ratio, age distribution and disease types in the dermatology department have undergone marked changes during the COVID-19 epidemic, and this study provides a reference for healthcare workers in dermatology department to respond to various epidemics and natural disasters in the future.
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A 9-year-old boy presented with pruritic erythema and erosions of the scalp for 1 month, which spread all over the body for 1 week. Histopathological examination of the skin lesions showed blisters forming under the granular layer of the epidermis, a large number of acantholytic cells in the blisters, and perivascular infiltration of lymphocytes and eosinophils in the superficial dermis. Direct immunofluorescence study showed reticular deposition of IgG and complement C3 between epidermal cells, and negative staining for IgM and IgA. Enzyme-linked immunosorbent assay showed the presence of serum anti-Dsg1 antibody (157.00 U/ml) . The patient was diagnosed with pemphigus foliaceus. After admission, the patient showed poor response to the treatment with prednisone at a dose of 40 mg/d. After the treatment with low-dose rituximab (100 mg per week, 4 weeks) combined with prednisone (20 mg/d) , her condition was well controlled. The dosage of prednisone gradually decreased to 7.5 mg/d for maintenance treatment, and no recurrence was observed during 24-month follow-up.
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Objective:To assess the application value of reflectance confocal microscopy (RCM) in evaluating clinical efficacy of hemoporfin-mediated photodynamic therapy for purple-type port-wine stain.Methods:From April 2018 to January 2020, a total of 39 patients with centrofacial purple-type port-wine stains were enrolled from Department of Dermatology, Wuhan No.1 Hospital, and received 3 sessions of hemoporfin-mediated photodynamic therapy. Before the first treatment, and 3- 6 months after 3 sessions of hemoporfin-mediated photodynamic therapy, skin lesions were photographed, and RCM was conducted to measure the diameter and density of blood vessels at a depth of 100 μm in the lesions. Clinical efficacy was evaluated based on the clinical photos, and the average diameter of blood vessels and density of blood vessels per square millimeter of lesion area were calculated. Measurement data were compared among different groups by using one-way analysis of variance, multiple comparisons were performed using least significant difference test, and comparisons of parameters before and after treatment were conducted by using paired t test. Results:After 3 sessions of hemoporfin-mediated photodynamic therapy, 1 (2.56%) patient was nearly completely cured, 16 (41.03%) received marked improvement, 20 (51.28%) received improvement, and 2 (5.13%) showed no response to the treatment. In the patients receiving marked improvement or improvement, the average diameter and density of blood vessels significantly decreased after treatment compared with those before treatment (all P < 0.05) , while no significant difference was observed before and after treatment in the patients with no response (both P > 0.05) . The average difference in the blood vessel diameter before and after treatment was significantly higher in the patients receiving marked improvement (48.56 ± 17.87 μm) than in those receiving improvement (31.15 ± 21.09 μm, P < 0.05) and those with no response (12.00 ± 2.83 μm, P < 0.05) . The average difference in the blood vessel density before and after treatment was 7.13 ± 3.44, 5.00 ± 2.22 and -0.50 ± 3.54 vessels/mm 2, respectively, in the patients receiving marked improvement, improvement and those with no response, and pairwise comparisons between the 3 groups all showed significant differences (all P < 0.05) . Conclusion:RCM can be used to assess the average diameter and density of blood vessels in the port-wine stain lesions before and after hemoporfin-mediated photodynamic therapy, and is helpful in quantitatively evaluating the therapeutic effect of hemoporfin-mediated photodynamic therapy.
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A 66-year-old female patient presented with blisters on the scalp and neck for 1 month. She had a history of type 2 diabetes for 6 years, and started taking the dipeptidyl peptidase-4 inhibitor linagliptin at a dose of 5 mg once a day 6 months before the onset of eruption. Skin examination showed scattered mung bean- to peanut-sized blisters on the scalp, and some blisters broke with exudation and crusts. There was a pigeon egg-sized bulla and two mung bean-sized blisters on the left neck, with tense blister walls, clear blister fluids, non-erythematous base, and Nikolsky′s sign was negative. Enzyme-linked immunosorbent assay revealed that the serum levels of anti-BP180 NC16A and anti-BP230 antibodies were 5.81 and 139.76 kU/L respectively. Histopathological examination of the blister on the neck showed subepidermal blister formation, and infiltration with neutrophils and a few eosinophils in the blister. The patient was finally diagnosed with localized anti-BP230-type bullous pemphigoid. This case of anti-BP230-type bullous pemphigoid associated with the dipeptidyl peptidase-4 inhibitor linagliptin was firstly reported in China.
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Objective To understand the distribution of allergens in children with common allergic diseases in Guangzhou, and to provide evidence for the prevention and treatment of environmental allergens in children with different allergic diseases. Methods This study enrolled a total of 6 869 children with allergic diseases, including wheezing diseases and asthma (1 013 cases), allergic rhinitis (660 cases), allergic conjunctivitis (422 cases), eczema (2 762 cases), atopic dermatitis (831 cases) and urticaria (1 181 cases). Western blotting was used to detect the serum allergen type E specific antibodies (sIgE) of the patients. The results were statistically analyzed. Results The total positive rate of sIgE in 6 869 children was 74.01%. The positive rate of male children (75.02%) was higher than that of female children (72.25%). The positive rate of inhalation allergens (53.47%) was higher than that of food allergens (57.39%). House dust mites and milk were the most common inhalation allergens and food allergens, respectively. Eczema was the most common allergic disease in infants and toddlers. Allergic rhinitis and urticaria were common in school-age children. Conclusion The main allergens causing allergic diseases in children in Guangzhou were dust mites and milk. Different allergic diseases had its specific allergens. It is necessary to take targeted prevention measures accordingly.
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Objective:To observe the effect of narrow band ultraviolet B (NB-UVB) treatment of patients with psoriasis vulgaris on the expression of Wnt5a and Frizzled2 signaling molecules and its relationship with skin lesions so as to explore the mechanism of treating psoriasis vulgaris with NB-UVB.Methods:Thirty-two patients with psoriasis vulgaris and 30 healthy volunteers were selected into a case group and a healthy control group. The case group was treated with NB-UVB irradiation for 8 weeks. The mRNA and protein associated with Wnt5a and Frizzled2 signaling molecules in the skin tissues of both groups were detected before and after the phototherapy using a reverse transcription-polymerase chain reaction and western blotting respectively. Psoriasis area and severity index(PASI) scores were recorded before and after the treatment for the case group, and the correlation between Wnt5a and Frizzled2 protein content and PASI score was analyzed.Results:Before the treatment the expression of Wnt5a and Frizzled2 molecular mRNA and protein in the lesioned area of the case group was significantly higher than in the healthy area of the case group and in the healthy group. It had decreased significantly after the treatment. Before the treatment, the expression of Wnt5a and Frizzled2 protein in the lesioned area was significantly and positively correlated with the severity of the disease. However, after the NB-UVB treatment, the average PASI score was significantly decreased. The expression of Wnt5a and Frizzled2 protein in the lesioned area was still significantly and positively correlated with the severity of the disease.Conclusion:NB-UVB irradiation can significantly reduce the mRNA and protein expression levels of Wnt5a/Frizzled2 signaling molecules in the lesions of patients with psoriasis vulgaris, which may be one of the mechanisms of NB-UVB in treating psoriasis.
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Objective To investigate dermoscopic,reflectance confocal microscopic (RCM) and histopathological features of trichoepithelioma.Methods A total of 23 outpatients with histopathologically confirmed trichoepithelioma were enrolled from Department of Dermatology,Wuhan No.1 Hospital between January 2017 and December 2018.Dermoscopic and RCM images were collected,and the consistency was analyzed between dermoscopic or RCM features and histopathological features.Results Among the 23 patients,5 were male,and 18 were female.Their age was 39.5 ± 22.1 years.Histopathological examination showed that the tumor was well-circumscribed and surrounded by abundant fiber matrices,consisted of many basaloid cells forming clusters or interlacing cords with surrounding cells arranged in a fence-like pattern.Tumor cells differentiated into dermal papilla cells to different extents,and varying amounts of keratinous cysts were observed.RCM showed bud-like downward extension of cord-like cells at the dermoepidermal junction in 8 patients,which tended to be arranged in a fence-like pattern;seemingly lobulating nodular tumor masses were scattered in the dermis in 18 patients,which appeared as extended hypoechoic structures,with no constriction gap between tumor masses and surrounding tissues;tumor masses were surrounded by moderately to highly refractive amorphous substance in 16 patients;characteristic hair papilla structures suspected to be derived from primary differentiation were observed in 16 patients;keratinous cysts were clearly observed in 20 patients.Dermoscopy clearly showed that homogeneous pearlwhite structures in 20 patients,and linear telangiectasia in 10 patients.Conclusion RCM features of trichoepithelioma are highly consistent with its histopathological features,so reflectance confocal microscopy can serve as an efficient method for auxiliary and differential diagnosis.
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Objective To investigate dermoscopic and reflectance confocal microscopic (RCM)features of sebaceous nevus in patients of different ages.Methods A total of 83 patients histopathologically diagnosed with sebaceous nevus were enrolled from Department of Dermatology of Wuhan No.1 Hospital between January 2016 and December 2016,and divided into 4 age groups (＜ 10 years,10-20 years,21-59 years,≥ 60 years) according to the age.The dermoscopic and RCM features were collected and analyzed.Results Among the age group of ＜ 10 years (21 cases),dermoscopic images of skin lesions showed that uniform,globular or plaque-shaped yellowish-red structures arranged in a cobblestone-like pattern were independently distributed in an orange background,with vascular proliferation and dilatation,while RCM images showed sebaceous gland hypoplasia and juvenile hair follicles.Among the age group of 10-20 years (28 cases),dermoscopy showed aggregated,non-hair follicle,round or oval yellow structures of varying sizes with telangiectases,while RCM showed botryoidal sebaceous glands at the dermal-epidermal junction and superficial dermis,which were characterized by tube-like or handle-like structure in the center,aggregated fish roe-like or frogspawn-like sebaceous gland lobules in the surrounding area and verrucous or papillomatous hyperplasia in the epidermis.The age groups of 21-59 years (30 cases) and 10-20 years showed the similar imaging manifestations.The main imaging manifestation of the age group of ≥ 60 years (4cases) was papillomatous hyperplasia.Conclusions Sebaceous nevus is a dynamic developmental disease,and its imaging characteristics obviously differ among different age stages.Sebaceous nevus has characteristic structures under dermoscopy and RCM,which can serve as efficient noninvasive diagnostic methods for sebaceous nevus.
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Objective To establish an athymic (nu/nu)BALB/c mouse model with chronic subcutaneous infection due to Phialophora verrucosa (P.verrucosa),and to explore the role of T lymphocytes in defensing against invasive infection due to P.verrucosa.Methods Six immunocompetent BALB/c mice and 6 nu/nu BALB/c mice were subcutaneously inoculated with 100 μl of P.verrucosa hyphae suspensions at a concentration of 5.0 × 108 colony-forming unit (CFU)/ml into one footpad,while another 6 immunocompetent BALB/c mice and 6 nu/nu BALB/c mice were subcutaneously inoculated with 100 μl of 5.0 × 108 CFU/ml P.verrucosa conidium suspensions into one footpad.The degree of footpad swelling was measured with a vernier caliper every 3 days.Histopathological characteristics of infected footpads were further analyzed.Biopsy tissues were also subjected to fungal culture to analyze the growth of P.verrucosa in infection foci in mice.Results After the treatment with hyphae or conidium suspensions,the BALB/c mice experienced transient footpad swelling within 12 days,and basically recovered after 50 days.However,the nu/nu BALB/c mice experienced persistent footpad swelling with recurrent ulceration and crusting.As pathological examination revealed,all the inoculation loci in BALB/c mice experienced local infection,and the morphology of P.verrucosa in the infected foci was not changed over time.However,invasive infections due to P.verrucosa hyphae alone or a mixture of P.verrucosa hyphae and sclerotic cells were observed in all the inoculation loci in nu/nu BALB/c mice.The fungal culture showed that P.verrucosa could not grow in the footpads of BALB/c mice after 21 days,while P.verrucosa could persistently grow in the footpads of nu/nu BALB/c mice.Conclusion An experimental model with subcutaneous phaeohyphomycosis due to P.verrucosa has been successfully established by using nu/nu BALB/c mice,and the nu/nu BALB/c mice are more susceptible to P.verrucosa infection compared with the immunocompetent BALB/c mice.
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A 54-year-old female farmer presented with a pea-sized red nodule on the left upper limb near the wrist for 15 days,which occurred after trauma,gradually became swollen and ruptured,and developed into multiple nodules arranged in a chain in 30 days.Skin examination revealed multiple hard purple-red nodules arranged in a line on her left upper limb,some of which were ruptured with a small amount of purulent exndate.Histopathological examination further revealed that the focus of infection manifested as pyogenic granuloma-like inflammation mainly infiltrated with mixed inflammatory cells.Periodic acid Schiff (PAS) staining showed no fungal structures,including fungal spores,hyphae and asteroid body.The biopsy tissue culture yielded the fungus.According to the morphological analysis of the cultures and results of molecular identification based on internal transcribed spacer (ITS) and calmodulin (CAL) coding regions,this case was finally diagnosed as lymphocutaneous sporotrichosis caused by Sporothrix schenckii sensu stricto.The patient was treated with oral potassium iodide 10％ solution in a dose of 10 ml thrice a day.After 2-month treatment,the patient felt that the lesions were obviously improved,but afterwards she was lost to follow-up.This research report suggests that phenotypic analysis combined with ITS/CAL-based molecular identification can accurately identify Sporothrix schenckii complex at the species level.
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Objective To establish an athymic (nu/nu)BALB/c mouse model with chronic subcutaneous infection due to Phialophora verrucosa (P.verrucosa),and to explore the role of T lymphocytes in defensing against invasive infection due to P.verrucosa.Methods Six immunocompetent BALB/c mice and 6 nu/nu BALB/c mice were subcutaneously inoculated with 100 μl of P.verrucosa hyphae suspensions at a concentration of 5.0 × 108 colony-forming unit (CFU)/ml into one footpad,while another 6 immunocompetent BALB/c mice and 6 nu/nu BALB/c mice were subcutaneously inoculated with 100 μl of 5.0 × 108 CFU/ml P.verrucosa conidium suspensions into one footpad.The degree of footpad swelling was measured with a vernier caliper every 3 days.Histopathological characteristics of infected footpads were further analyzed.Biopsy tissues were also subjected to fungal culture to analyze the growth of P.verrucosa in infection foci in mice.Results After the treatment with hyphae or conidium suspensions,the BALB/c mice experienced transient footpad swelling within 12 days,and basically recovered after 50 days.However,the nu/nu BALB/c mice experienced persistent footpad swelling with recurrent ulceration and crusting.As pathological examination revealed,all the inoculation loci in BALB/c mice experienced local infection,and the morphology of P.verrucosa in the infected foci was not changed over time.However,invasive infections due to P.verrucosa hyphae alone or a mixture of P.verrucosa hyphae and sclerotic cells were observed in all the inoculation loci in nu/nu BALB/c mice.The fungal culture showed that P.verrucosa could not grow in the footpads of BALB/c mice after 21 days,while P.verrucosa could persistently grow in the footpads of nu/nu BALB/c mice.Conclusion An experimental model with subcutaneous phaeohyphomycosis due to P.verrucosa has been successfully established by using nu/nu BALB/c mice,and the nu/nu BALB/c mice are more susceptible to P.verrucosa infection compared with the immunocompetent BALB/c mice.
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Objective To analyze clinical characteristics of pemphigoid nodularis. Methods Seven cases of pemphigoid nodularis were included in this retrospective study. The clinicopathological features of pemphigoid nodularis were retrospectively analyzed, including patients′gender, age at onset, clinical manifestations, treatment and follow?up. Results Of the 7 patients, 4 were female and 3 were male, with the median age at onset being 59 years. Clinical manifestations mainly included markedly pruritic prurigo?like lesions and nodular lesions with or without blisters. The most common misdiagnoses were nodular prurigo and eczema. Pathology showed epidermal hyperplasia and subepidermal clefts, collagen hyperplasia in the papillary dermis, and perivascular infiltration of lymphocytes and eosinophils in the superficial dermis in all the patients. Direct immunofluorescence assay showed linear deposition of IgG and C3 in the basement membrane zone, and indirect immunofluorescence was positive in 2 patients. Glucocorticoids combined with immunosuppressants were effective in all the patients. Conclusions Pemphigoid nodularis is easy to be misdiagnosed, and immunopathology is helpful for its diagnosis. Glucocorticoids combined with immunosuppressants appear to be effective for its treatment.
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Objective Discussing the correlation between joint detection of procalcitonin(PCT) ,hypersensitive c‐reactive protein (hs‐CRP) ,WBC and bronchopneumonia in children .Methods Choosing 89 bacterial infection bronchopneumonia children ,92 virus infection bronchopneumonia children ,90 mycoplasma infection bronchopneumonia children and 100 normal children ,detecting their PCT ,hs‐CRP ,WBC and statistical analysis of the level of parallelism .Results There is a positive correlation between bacterial in‐fection group′s PCT and hs‐CRP ,WBC(r=0 .807 ,0 .764 ,P<0 .05) .The joint detection of PCT ,hs‐CRP ,WBC positive rate in bac‐terial infection group is significantly higher than the rest group(P<0 .05) .Conclusion PCT ,hs‐CRP and WBC is a sensitive indica‐tor of bacterial infection .There is important clinical reference value in joint detection to the diagnosis of bacterial infection broncho‐pneumonia in children ,in dynamic monitoring the disease progression ,and in prognosis judgement .
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Objective To discuss the correlation between the joint detection of BA,EMAb,ACA and unexplained recurrent spontaneous abortion(URSA).Methods Selected 144 URSA cases,166 SA(sporadic abortion)cases,188 normal pregnant women,and detected their BA,EMAb,ACA and statistical analysis of parallelism.Results Comparing URSA group with SA group and control group respectively,there were significant statistical difference between BA negative rate (74.31%, 25.30% and 50.53%),EMAb positive rate (35.42%,7.23% and 6.91%)and ACA positive rate (26.39%,5.42% and 5.32%)(χ2 = 19.344 ~ 74.180;P < 0.05;χ2 = 37.837 ~ 42.586,P < 0.05),(χ2 = 26.355 ~ 29.270,P < 0.05).URSA group’s BA,ACA and EMAb joint detection rate of positive (84.72%)was significantly higher than SA group and the con-trol group (χ2 =35.532~93.076,P <0.05).Conclusion There was a close relationship between the lack of BA,the genera-tion of EMAb,ACA and unexplained recurrent spontaneous abortion.Joint detection has important clinical significance in auxiliary diagnosis of unexplained recurrent spontaneous abortion and prognosis judgement.
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<p><b>OBJECTIVE</b>To study the clinicopathologic features, immunophenotype and gene rearrangement of primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL).</p><p><b>METHODS</b>Seven cases of PCLBCL were enrolled into the study. Clinicopathologic analysis, immunohistochemical staining and gene rearrangement for IgH and Igκ were undertaken in the study.</p><p><b>RESULTS</b>All the seven cases were male, and the median age was 72 years. Patients usually presented with multiple purple tumors, nodules, papules and infiltrative plaques. Two patients had a history of leg injury before onset, and one had mosquito bites. Histologically, the tumor involved the dermis and subcutis with dense and diffuse infiltrative pattern composing of centroblasts and/or immunoblasts. Immunohistochemical staining showed that seven cases (7/7) expressed CD20, six (6/6) expressed bcl-2, four (4/4) expressed MUM-1, four (4/5) expressed CD79a, four (4/5) expressed PAX-5 and four (4/6) expressed bcl-6, respectively. All cases did not express CD3ε, CD45RO, CD10 and CD30. IgH gene rearranged bands were detected in three (3/6) cases and Igκ was detected in one (1/5) case. Six of the seven cases died and the remaining patient, who was 44-year-old, was alive after 22 months of follow-up.</p><p><b>CONCLUSIONS</b>PCLBCL is rare, predominantly affects elderly male patients. PCLBCL has poor prognosis and high mortality, but younger patients seem to have better prognosis. Some cases had a history of trauma or mosquito bites. The relationship between the history and the onset of PCLBCL needs further evaluation.</p>