Primary detection of pathogen from children with hand, foot, and mouth disease in Beijing, 2007 / 病毒学报

We investigated the causative agents of hand, foot and mouth disease (HFMD) in children in Beijing epidemic from April to June of 2007. Totally, 82 specimens (including throat swabs, rectal swabs and vesicular swabs) were collected from 51 patients with HFMD. All patients had typical skin lesions, but no neurological manifestations. These clinical specimens were directly tested by RT-PCR assay with three primer sets: universal enterovirus, CA16-specific and EV71-specific primers. Enterovirus, CA16 and EV71 were identified depending on the size of PCR products. The percentage of the specimens identified as positive for enterovirus was 70.6%. Of the 51 cases, 25 were positive for CA16, 4 were positive for EV71, and 7 were enterovirus positive of non-CA16 or EV71. The ratio among them was about 6:1:2. EV71 strains belonged to genotype C4 after sequencing and phylogenetic analysis.

Clinical characteristics and treatment options of cutaneous vessel abnormalities / 中国医学科学院学报

<p><b>OBJECTIVE</b>To summarize the clinical characteristics and treatment options of cutaneous vessel abnormalities.</p><p><b>METHODS</b>The clinical data of 384 pediatric patients with cutaneous vessel abnormalities who were treated in Beijing children's Hospital from January 2007 to December 2007 were retrospectively analyzed. Patients were classified according to International Society for the Study of Vascular Anomalies (ISSVA) classification method.</p><p><b>RESULTS</b>Of the 384 patients, infantile hemangioma was confirmed in 185 patients (male : female = 1 : 1.7). Most children (78.4%) were taken to our department when they were within six months. The skin injuries were mainly located on the head and face (50.8%). Congenital hemangioma was confirmed in 132 patients (male : female = 1 : 1.9). Most children (75.0%) were taken to our department when they were within six months. The skin injuries were mainly located on the head and face (37.1%). Capillary malformation was confirmed in 27 patients (male: female = 1 : 1.3). Most children (40.7%) were taken to our department when they were within one year old. The skin injuries were mainly located on the head and face (77.8%). Venous malformation was confirmed in 16 patients (male : female = 1 : 1.3). Most children (31.3%) were taken to our department when they were within one year old. The skin injuries were mainly located on the head and face (56.3%). Of the 384 patients, 250 patients (65.1%) were treated by watching and waiting. Eighty of these 250 patients were followed up, which showed that, when these children were 1. 5-2 years old, the lesions' color lightened and their areas reduced by half and lesions almost disappeared in 34 patients.</p><p><b>CONCLUSIONS</b>Infantile hemangioma and congenital hemangioma are two common cutaneous vessel abnormalities in children. Their incidences were higher in female than in male. Cutaneous vessel abnormality with endothelial cell proliferation has an earlier onset age. Skin injuries are mostly seen in face. Most pediatric patients experience good prognosis after being treated with watching and waiting.</p>

Relationship between hydroa vacciniforme-like cutaneous lymphoma and chronic active Epstein-Barr virus infection / 中华皮肤科杂志

Objective To report 6 cases of hydroa vacciniforme-like cutaneous lymphoma,and to inves- tigate the relationship between this disorder and Epstein-Barr virus(EBV)infection.Methods Pathological and immunohistochemical examinations were performed in the biopsy specimens obtained from all 6 patients. Skin lesions were subjected to EBV encoded RNA(EBER)detection by in situ hybridization.Serological assay and quantification of EBV DNA were performed.Results All the 6 patients had recurrent papules, papulovesicles,necrosis and variola-like scar with chronic intermittent fever;four of the patients also presented with edema of the face,hands and feet.Pathologically,there were multilocular vesicles in the epidermis,and large numbers of infiltrating lymphocytes through the dermis.The cells were atypical with mitotic figures. Immunohistochemical staining of the lesions of 4 patients showed large quantities of cells expressing CD56, scattered cells expressing CD3 and CD45RO,and cells expressing grazyme B and T cell intracellular antigen-1 (TIA-1);a diagnosis of hydroa vacciniforme-like cutaneous NK/T lymphoma was made in these 4 cases. In the lesions of another 2 patients,the cells expressing CD3 and CD45RO,but not CD56,were observed; the diagnosis of hydroa vacciniforme-like cutaneous T-cell lymphoma was made in them.EBER was detected in the tumor cells of all the 6 patients.The IgG titers of anti-Epstein-Barr viral capsid antigen increased in all patients(1:5120 in 2 cases,1:2560 in 2 cases,1:1280 in 2 cases).The copies of EBV DNA were increased in the peripheral blood of both the two detected cases.A chronic active EBV infection was confirmed in all patients.Conclusions Hydroa vacciniforme-like cutaneous lymphoma is clinically characterized by edema of face,hands and feet,vesicular eruptions and variola like scars;histologically,it is characterized by infiltrates of atypical cells consistent with lymphoma,and necrosis in the center of vessels.NK/T is the primary immunophenotype of this disease.There is a close association between chronic active EBV infection and hydroa vacciniforme-like cutaneous lymphoma.

Chronic Pulmonary Complications Associated with Toxic Epidermal Necrolysis Caused by Carbamazepine / 实用儿科临床杂志

Objective To explore the clinical manifestations of toxic epidermal necrolysis(TEN) and its rare pulmonary complications.Methods Clinical symptoms,treatment and prognosis of 1 child with TEN caused by carbamazepine were analyzed.Radiological images were reviewed to evaluate the manifestations and the outcome of chronic pulmonary complications associated with TEN.Results The patient had high fever shortly after a dosage increment of carbamazepine.A confluent erythematous exanthema developed rapidly into painful blistering with skin erosion,denudation and involvement of conjunctive and oropharyngeal mucosa.The diagnosis of TEN was made.The mucocutaneous damage was gradually recovered with steroid plus intravenous immunoglobulin for 3 weeks.However,the patient presented with respiratory failure in the recovery phase of TEN.The computer tomography revealed pulmonary bullae and pneumothorax in the right lung.Lung parenchyma was squeezed and pulmonary bullae ruptured with pneumothorax and atelectasis,which were absorbed gradually through thoracic drainages.The patient′s lung function and pulmonary bullae were partly improved during a 7-month follow-up.Conclusions TEN is a severe form of blistering skin di-sease which is characterized by an extensive loss of epidermis and mucous membrane.Chronic pulmonary complications may occur in recovery phase of TEN.Pulmonary bullae,which might be caused by mucous damage and respiratory obstruction,is a rare complication of TEN.