Clinical Manifestations of Adult Langerhans Cell Histiocytosis with Multisystem Involvement Successfully Treated Using Chemotherapy

Introduction:Langerhans cell histiocytosis(LCH),the most common histiocytic disorder,characterized by the abnormal over production of histiocytes that tend to infiltrate single or multiple organ systems leading to significant tissue damage.Case presentation:We describe a 23-year-old man suffering from central diabetes insipidus,"hemorrhoids",progressive hearing loss and a surge in weight.Physical examination revealed lesion involvement of the skin and mucous membranes,including the perianal area,gingiva,and external auditory canal.He was diagnosed as LCH,who achieved remission following a chemotherapy regimen.Discussion:LCH is common in children,but it is not surprising to see it in adults.The clinical manifestations of LCH are highly variable and may involve multiple organs and systems.While,skin involvement is the most obvious symptom,and dermatologists should be familiar with it.Chemotherapy is the first-line treatment for multisystem or multifocal single system adult LCH.Conclusion:Characteristic features of LCH involving the perianal area was described in this case which helped the dermatologist to make quick judgments.We also emphasize that a global concept should be established confronting with a patient with multiple complaints.

Factors Associated with Development of Vitiligo in Patients with Halo Nevus

Background： Halo nevus （HN） has been shown to be associated with vitiligo, but no standard signs are currently available to identify HN patients at risk of vitiligo, and the relevant data obtained in previous studies are somewhat conflicting. This study aimed to identify factors affecting the presence of vitiligo in HN patients. Methods： We performed a retrospective study on consecutive patients with HN at the First Affiliated Hospital of Sun Yat-sen University between January 2011 and December 2016. Detailed demographic and clinical data were collected to identify the factors associated with the presence ofvitiligo in this cohort of patients using uni- and multi-variate logistic regression analyses. Results： A total of 212 HN patients were included, 101 of whom had vitiligo-associated HN （HNV）. Univariate analysis indicated that a personal history of thyroid diseases was positively associated with HNV （odds ratio [OR] 10.761, P = 0,025）, while the onset age of HN was negatively associated with HNV （OR =0.537, P= 0.026）. Multivariate analysis demonstrated that the Koebner phenomenon （KP： OR = 10.632, P 〈 0.0001）, multiple HN （OR = 3.918, P 〈 0.0001）, and a familial history of vitiligo （OR = 3.222, P= 0.014） were independent factors associated with HNV. Conclusions： HN without vitiligo has clinical features distinct from HN associated with vitiligo. HN patients with KR multiple lesions, or familial history ofvitiligo are more likely to develop vitiligo and theretbre should be monitored for clinical signs of such accompanied conditions.

Consensus by Chinese Expert Panel on Chlamydia trachomatis-Resistant and Chlamydia trachomatis-Persistent Infection

Chlamydia trachomatis （Ct） genital infection is the most common sexually transmitted disease （STD） in China and the US. The morbidity of Ct genital infection in China has increased from 32.48/100,000 in 2008 to 37.18/100,000 in 2015.[1] The major areas of Ct infections are concentrated in the Zhujiang Delta, Changjiang Delta, Minjiang Area, and West China. In these areas, the highest incidence of Ct infection reaches 615.99/100,000 citizens. In the US, there are 1,441,789 reported Ct, which include 627.2 females and 278.4 males per 100,000 population. It is now the most prevalent STD, with its rate increasing to 22% in males and 6% in females.[2] Ct genital infection can cause epididymitis, prostatitis, cervicitis, annexitis, infertility, and atopic pregnancy, which have been identified as the major public health problems.