伊曲康唑治疗花斑癣52例疗效观察

我们从1999年4月～2000年3月用伊曲康唑治疗花斑癣52例,获得满意疗效,现将结果报告如下 1材料与方法 1.1临床资料门诊选择经临床和真菌镜检确诊的花斑癣共52例.     

江西地区花斑癣患者马拉色菌菌种分析

目的了解江西地区花斑癣患者马拉色菌菌种分布情况。比较传统吐温试验和改良吐温试验。方法对141例临床典型、真菌镜检阳性的花斑癣患者,采用Leeming和Notman培养基培养皮屑。以标准菌株为对照,按形态学和生理生化特点进行分类,分析马拉色菌菌种构成情况。同时比较传统吐温试验和改良吐温试验优缺点。结果培养到95株马拉色菌,分离出5个菌种:合轴马拉色菌62株,糠秕马拉色菌17株,球形马拉色菌9株,钝形马拉色菌6株,限制马拉色菌1株。结论合轴马拉色菌占有明显优势(65.26%)。改良吐温试验易于操作、费时短,尤其适合多标本的流行病学调查研究,值得推广。     

难辨认体癣1例

1临床资料 患者女,35岁,因左膝部反复出现皮损,渐扩大13a就诊。13a前左膝部皮肤曾经发生过碰伤,导致局部红肿,未治疗而自愈。之后每年春、夏季节左膝部皮肤发红、伴瘙痒并逐渐扩大。曾在当地医院按“风湿性关节炎、湿疹”等对症治疗,口服泼尼松、吲哚美辛（商品名“消炎痛”）、特非那定等药,外用复方地塞米松霜（商品名“皮炎平”）、复方酮康唑霜（商品名“皮康王”）等,皮损有好转。     

声带曲霉感染1例

患者女,21岁,因声嘶2个月于2007年3月20日入院、患者于2007年1月感冒后出现发热、咳嗽,3d后出现声嘶,经当地医院予抗感染治疗和糖皮质激素治疗2个月无效（具体用药不详）,声嘶渐加重至失声。入院查体、化验检查均未见异常,电子鼻咽喉镜查示：双声带充血,前中部白色伪膜样物附着,左声带肥厚,声门闭合欠佳,[第一段]     

面癣误诊1例

1资料与方法1.1临床资料患者,女,34岁,农民。因面部皮疹伴瘙痒4个月加重1周就诊。4个月前右侧面颊部出现一约黄豆大小红色环形皮损,伴瘙痒。当地诊所诊断为“过敏性皮炎”,给予外用“肤轻松”、“皮康霜”,同时口服扑尔敏治疗1周,皮疹减轻。停药后复发。此后曾在当地多家医院按“皮炎、湿疹”治疗,外用“皮炎平”“尿素软膏”“皮康王”,口服“息斯敏”“特非那丁”“赛庚啶”“西替利嗪”等药物。开始用药时红斑均略减轻,但皮疹反复发作且面积逐渐扩大。近一周来皮疹明显扩大,瘙痒加剧,遂于2005年12月27日来我科就诊。患者既往体健,无糖尿…     

降纤酶皮试阳性1例报告

1　临床资料　　患者 ,男 ,48岁 ,因头痛、头晕 1周就诊 ,查血压 2 4 .0 / 1 7.3 k Pa。缺血性脑中风预测 :临界一级。全血比粘度 4.71 (正常值 3.8～ 4.6) ;血浆比粘度 1 .83(正常值 1 .45～ 1 .80 ) ;血小板粘附率 46(正常值 1 8.8～ 38.8)。诊断 :高血压病。因患者血粘度三项指标高于正常水平 ,决定给予静滴降纤酶。首先以 0 .1 ml内含 0 .0 0 0 2 5u皮内注射试敏。1 5min观察结果 ;皮丘 0 .7cm× 0 .7cm,周围红晕3.5cm× 4.0 cm,可见明显伪足 ,自诉局部瘙痒。判断 :降纤酶皮试阳性 ,追问有漆过敏史。2　讨论　　降纤酶是在原蝮蛇抗栓酶…     

正圆形秕糠疹样体癣1例

1 资料与方法 1.1 临床资料 患者男27岁,屠宰厂工人。1996年3月右小腿伸侧无明确诱因出现2个圆形暗褐色斑疹．皮疹表面干燥,并覆有细薄糠秕状鳞屑．充满整个圆形斑．不易剥脱。曾在当地医院诊治．考虑为体癣,给予小剂量伊曲康唑并用一此外用药（药品不详）间歇治疗近2年。     

7例不典型肺真菌病的临床分析

目的 肺部真菌感染往往症状不典型,肺部影像学表现多样,缺乏特异性,为早期诊断和治疗带来困难。尤其足近年来无免疫缺陷人群中也出现肺部真菌感染．使临床判断更加复杂。方法 对我院于2006年上半年收治的7例无免疫缺陷的肺部真菌感染病例,从发病特点、临床表现、影像学、病原学、诊断依据以及治疗策略等方面对其进行了详细分析。结果 7例肺真菌病患者均无明显免疫缺陷,肺部影像学表现多样。通过血清学、肺活检、痰培养等方法确诊,对治疗反应均较好。结论 肺真菌病的临床表现趋向复杂多样,临床医生应予以高度重视。     

黄曲霉感染致复发性肺不张1例

肺曲霉菌病（pulmonary aspergillosis,PA）是肺部真菌感染的常见类型,患者多有肺部基础病变或免疫功能异常,其影像学表现呈现多样性,诊断较为困难[1,2]。本文报告1例肺部黄曲霉感染致右上肺反复发生肺不张5年,最后经伊曲康唑治疗后痊愈病例。     

库特氏棒状杆菌败血症1例报告

库特氏棒状杆菌败血症１例报告云南省玉溪地区医院，云南省医学微生态研究中心６５３１００陈宗淦，鲁慎文，朱江，刘姝惠云南省玉溪地区卫校史云丽我们从１例发热、贫血患者骨髓和血液中均分离出库特氏棒状杆菌，现报告如下。１．临床资料患者，女，５２岁，回族，工人，...     

易与花斑糠疹混淆的融合性网状乳头瘤病合并黑棘皮病1例

融合性网状乳头瘤病为一种少见的原因不明的皮肤病,不易诊断。多见于青少年,好发于躯干部和腋窝,为褐色鳞屑性斑片或斑块。临床易误诊而被延误治疗。报告1例融合性网状乳头瘤病合并黑棘皮病,曾被多次拟诊为"花斑糠疹",有较典型的临床表现和组织病理改变。口服及外用异维A酸治疗有效。     

Uncommon cases of pityriasis versicolor

Malassezia may play a role in several dermatoses. It is responsible for foliculitis and mainly for pityriasis versicolor. Pityriasis versicolor is the most known dermatitis because of its clinical aspects and frequently for its poor response to the therapy, mainly in chronic forms. The clinical aspects of uncommon and rare forms of pityriasis versicolor have been reported. The data related to the patients observed in the last thirty years in Siena are reported. In addition, a study was carried out in Pisa by Professor F. Mancianti to identify species of Malassezia isolated in 37 patients.     

A study of pityriasis versicolor in Bangkok (Thailand)

A total of 410 cases of pityriasis versicolor were studied in the Division of Dermatology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand, during January to December 1987. These comprised 1% of all skin disorders, while infection caused by fungus comprised 17%. Most persons infected with pityriasis versicolor were 12–21 years old (mean age 20 years) and 47% were male and 53% were female. The common sites of infection were back, arms, face and trunk. The colors of lesions found were white (83%), brown (7%), pink (6%) and ashy (4%). Both forms of M. furfur were isolated, the ovale form in 97% and the orbiculare form in 3% of cases. The colors of the lesions did not depend on the form of the organism. Mycological and immunological studies confirmed that the two forms were different stages in the complex developmental cycle of a single species.     

Sparing of the upper axillary area in pityriasis versicolor

Increased temperature and sweating are considered factors predisposing to pityriasis versicolor. In this case report, sparing of the vaults of the axillae which are naturally occluded and sweaty areas, in a patient with widespread lesions of pityriasis versicolor is discussed. It is the second observation in this regard and further contributions are invited.     

Prevalence of Malassezia species in pityriasis versicolor lesions in northeast Argentina

BackgroundMalassezia species normally colonize the skin but they can change their saprophytic state and invade the stratum corneum as pathogens.AimsTo determine the prevalence of Malassezia species isolated from patients with pityriasis versicolor (PV) and to analyse their distribution according to the location of the lesion on the body.MethodsThis study included 218 patients with PV and positive Malassezia cultures who resided in the city of Resistencia, a subtropical area located in northeast Argentina. Age, gender, and the body site of lesions were recorded. Strains were identified by PCR-RFLP.ResultsMalassezia sympodialis (37.7%) and Malassezia globosa (37.2%) were the most prevalent species isolated alone or in association with other Malassezia species in 82% of the patients. Malassezia furfur (21.3%) was the third most common species, followed by Malassezia slooffiae (1.7%), and Malassezia restricta (1.3%), which was found only in combination with M. globosa and M. sympodialis. Malassezia dermatis (0.4%) and Malassezia pachydermatis (0.4%) were each isolated once. None of the species affected a body site with statistical significance. Significant difference between genders according to age was found only in the 31–40-year-age group.ConclusionsThis study suggests that M. sympodialis and M. globosa represent the main species implicated in the pathogenicity of PV. M. furfur appears to be the third agent of importance in this geographical area. Statistical analyses showed none of the species was particularly associated with any one of the body sites.     

Exfoliative cytology of atypical polypoid adenomyoma. A case report.

BACKGROUND: An atypical polypoid adenomyoma (APA) is a well-defined entity. It occurs in the endometrium, lower uterine segment and endocervix. It is usually composed of atypical complex glands with squamous metaplasia admixed with myofibromatous stroma. CASE: A 35-year-old female presented with one-year history of irregular menstrual periods. A diagnosis of adenocarcinoma in situ was rendered on her cervicovaginal smear. Pelvic examination revealed an enlarged uterus due to a leiomyoma. Colposcopic examination revealed a 0.6-cm, sessile, polypoid mass at the junction of the endocervix and ectocervix. A cone biopsy of the lesion showed irregular, endometrial-type glands embedded in a prominent myofibromatous stroma. The atypical glandular component of the mass demonstrated varying degrees of architectural complexity, ranging from simple to complex hyperplasia. In tissue sections the lesion was diagnosed as APA of the cervix. The patient underwent a hysterectomy for the leiomyoma. The hysterectomy specimen showed an 8.5-cm leiomyoma. The cervix and uterine corpus revealed no residual APA. CONCLUSION: APA of the cervix should be considered among the differential diagnoses of atypical glandular cells of undetermined significance. The diagnosis of APA cannot be made on cytology; the final diagnosis requires histologic confirmation.     

Cytologic findings of atypical adenosis of the breast. A case report

BACKGROUND: Atypical apocrine adenosis, a well-described histopathologic entity, can sometimes be misdiagnosed as carcinoma. Apocrine cells can also appear atypical in cytopathology and be mistaken for carcinoma. Occasional case reports describe false positive cases due to the presence of apocrine cells in a few cases of radial scars and atypical apocrine metaplasia and in a degenerated cyst. CASE: A 37-year-old female underwent ultrasound-guided fine needle aspiration of an ill-defined breast nodule. The aspirate showed clusters and single cells containing abundant granular to focally vacuolated cytoplasm; enlarged, pleomorphic nuclei with irregular nuclear membranes; granular chromatin; and prominent nucleoli. These cells were distinct from and larger than the surrounding ductal and myoepithelial cells. Excision showed a nodular area of atypical apocrine adenosis adjacent to previous biopsy changes, correlating with the cytologic findings. CONCLUSION: Atypical apocrine adenosis can mimic carcinoma in histopathology and cytopathology. One should be cautious when reviewing apocrine cells in cytology, given their atypical features, especially their single, dispersed nature. However, the presence of accompanying benign cellular elements supports a benign diagnosis. Surgical biopsy should be recommended based on the cytologic findings.