Background: Pseudoepitheliomatous hyperplasia (PEH), a histological mimic of squamous cell carcinoma, is an exuberant reactive epithelial proliferation that may be induced by a variety of infectious, traumatic, inflam...Background: Pseudoepitheliomatous hyperplasia (PEH), a histological mimic of squamous cell carcinoma, is an exuberant reactive epithelial proliferation that may be induced by a variety of infectious, traumatic, inflammatory and neoplastic conditions of the skin and mucous membranes. PEH has been described in association with Spitz nevi and intramucosal nevi but not with oral malignant melanoma. Methods and results: A case of PEH in malignant melanoma of the palate in a 46-year-old female patient has been described. A search of the English literature did not disclose any previously reported case of such event. Conclusions: PEH associated with oral malignant melanoma is apparently very rare and most likely originates from the surface epithelium. This is in contrast with PEH in cutaneous melanoma where follicular or eccrine units have been suggested to be the origin.展开更多
AIM: To investigate the content of endotoxin in Pseudo epitheliomatous hyperplastic granuloma like lesions and its pathogenic mechanism. METHODS: Endotoxin concentrations in the tissue were measured with chromogenic l...AIM: To investigate the content of endotoxin in Pseudo epitheliomatous hyperplastic granuloma like lesions and its pathogenic mechanism. METHODS: Endotoxin concentrations in the tissue were measured with chromogenic limulus amebocyte lysate (LAL), which was modified by perchloric acid (PCA) pretreatment for samples. To observe the effect of supernate from peripheral blood mononuclear cells by single or repeated endotoxin stimulation. on proliferation of cultured fibroblasts peripheral blood mononuclear cells. RESULTS: Endotoxin was detected in the injured skin but not detected in the normal skin. Supernate from rom peripheral blood mononuclear cells by single endotoxin stimulation has stronger effect on proliferation of fibroblats than repeated stimulation. CONCLUSION: Pseudo epitheliomatous hyperplastic granuloma like lesions were resulted from the bacteria in the injured shin, the bacteria produced endotoxin which stimulated the local inflammatory cells to produce cytokines,and the cytokines led to the overgrowth of repairing cells in the skin.展开更多
Background: Retinoids have the capacity to accelerate the involution ofmultiple keratoacanthomas, including unusual variants such as keratoacanthoma marginatum centrifugum and keratoacanthoma en plaque that may persis...Background: Retinoids have the capacity to accelerate the involution ofmultiple keratoacanthomas, including unusual variants such as keratoacanthoma marginatum centrifugum and keratoacanthoma en plaque that may persist and be associated with progressive growth and provide difficulties in diagnosis and management. Observations: We describe 3 patients who had unusual infiltrated and keratotic plaques affecting the lower legs or nasolabial area that persisted or recurred that may be related to this group of unusual keratoacanthomas. The 3 patients had differing clinical lesions that did not resemble classic keratoacanthomas, but were linked by their biopsy findings of hypertrophic lichen planus-like reaction and pseudoepitheliomatous hyperplasia with a prominent infundibulocystic component that progressed to multiple keratoacanthomas or infundibulocystic squamous cell carcinoma. Polymerase chain reaction analysis of biopsy material from 2 patients failed to detect human papillomavirus. All 3 presentations provided a therapeutic dilemma, but responded rapidly to acitretin treatment at a dosage of 10 to 25 mg daily, which was continued for 15 to 24 months. Conclusions: These cases illustrate an unusual reaction pattern that is hypertrophic lichen planus-like but, instead of evolving to classic lichen planus, progresses to infundibulocystic hyperplasia and the development of multiple keratoacanthomas or infundibulocystic squamous cell carcinomas. Retinoids represent a therapeutic option for this difficult clinical problem and may obviate repeated and extensive surgery.展开更多
临床资料患者，女，59岁，菜农。左侧面部红斑、结痂7个月。患者7个月前无明显诱因左侧面部出现粉刺状小丘疹，搔抓后逐渐增大，无自觉症状。无外伤史、类似家族史及其他病史。查体：系统查体未见异常。皮肤科检查：左侧面部见一直径约3...临床资料患者，女，59岁，菜农。左侧面部红斑、结痂7个月。患者7个月前无明显诱因左侧面部出现粉刺状小丘疹，搔抓后逐渐增大，无自觉症状。无外伤史、类似家族史及其他病史。查体：系统查体未见异常。皮肤科检查：左侧面部见一直径约3 cm圆形暗红色隆起性斑块，边界清楚，中央附有黄黑色结痂（图1）。实验室检查：血常规，肝、肾功能均正常。皮损病理检查示：表皮结痂，假上皮瘤样增生，较多嗜中性粒细胞移入表皮。真皮内较多嗜中性粒细胞、淋巴细胞及浆细胞混合性浸润，并见上皮样细胞肉芽肿（图2）。 PAS 染色：未见菌丝及孢子结构。真菌镜检及培养：申克孢子丝菌（图3）。结合临床表现，诊断为孢子丝菌病。治疗：伊曲康唑100 mg，日2次；局部热敷。治疗2个月后，皮损明显好转，面部红色斑块颜色变暗，浸润减轻，覆少许鳞屑（图1）。展开更多
文摘Background: Pseudoepitheliomatous hyperplasia (PEH), a histological mimic of squamous cell carcinoma, is an exuberant reactive epithelial proliferation that may be induced by a variety of infectious, traumatic, inflammatory and neoplastic conditions of the skin and mucous membranes. PEH has been described in association with Spitz nevi and intramucosal nevi but not with oral malignant melanoma. Methods and results: A case of PEH in malignant melanoma of the palate in a 46-year-old female patient has been described. A search of the English literature did not disclose any previously reported case of such event. Conclusions: PEH associated with oral malignant melanoma is apparently very rare and most likely originates from the surface epithelium. This is in contrast with PEH in cutaneous melanoma where follicular or eccrine units have been suggested to be the origin.
文摘AIM: To investigate the content of endotoxin in Pseudo epitheliomatous hyperplastic granuloma like lesions and its pathogenic mechanism. METHODS: Endotoxin concentrations in the tissue were measured with chromogenic limulus amebocyte lysate (LAL), which was modified by perchloric acid (PCA) pretreatment for samples. To observe the effect of supernate from peripheral blood mononuclear cells by single or repeated endotoxin stimulation. on proliferation of cultured fibroblasts peripheral blood mononuclear cells. RESULTS: Endotoxin was detected in the injured skin but not detected in the normal skin. Supernate from rom peripheral blood mononuclear cells by single endotoxin stimulation has stronger effect on proliferation of fibroblats than repeated stimulation. CONCLUSION: Pseudo epitheliomatous hyperplastic granuloma like lesions were resulted from the bacteria in the injured shin, the bacteria produced endotoxin which stimulated the local inflammatory cells to produce cytokines,and the cytokines led to the overgrowth of repairing cells in the skin.
文摘Background: Retinoids have the capacity to accelerate the involution ofmultiple keratoacanthomas, including unusual variants such as keratoacanthoma marginatum centrifugum and keratoacanthoma en plaque that may persist and be associated with progressive growth and provide difficulties in diagnosis and management. Observations: We describe 3 patients who had unusual infiltrated and keratotic plaques affecting the lower legs or nasolabial area that persisted or recurred that may be related to this group of unusual keratoacanthomas. The 3 patients had differing clinical lesions that did not resemble classic keratoacanthomas, but were linked by their biopsy findings of hypertrophic lichen planus-like reaction and pseudoepitheliomatous hyperplasia with a prominent infundibulocystic component that progressed to multiple keratoacanthomas or infundibulocystic squamous cell carcinoma. Polymerase chain reaction analysis of biopsy material from 2 patients failed to detect human papillomavirus. All 3 presentations provided a therapeutic dilemma, but responded rapidly to acitretin treatment at a dosage of 10 to 25 mg daily, which was continued for 15 to 24 months. Conclusions: These cases illustrate an unusual reaction pattern that is hypertrophic lichen planus-like but, instead of evolving to classic lichen planus, progresses to infundibulocystic hyperplasia and the development of multiple keratoacanthomas or infundibulocystic squamous cell carcinomas. Retinoids represent a therapeutic option for this difficult clinical problem and may obviate repeated and extensive surgery.
文摘临床资料患者，女，59岁，菜农。左侧面部红斑、结痂7个月。患者7个月前无明显诱因左侧面部出现粉刺状小丘疹，搔抓后逐渐增大，无自觉症状。无外伤史、类似家族史及其他病史。查体：系统查体未见异常。皮肤科检查：左侧面部见一直径约3 cm圆形暗红色隆起性斑块，边界清楚，中央附有黄黑色结痂（图1）。实验室检查：血常规，肝、肾功能均正常。皮损病理检查示：表皮结痂，假上皮瘤样增生，较多嗜中性粒细胞移入表皮。真皮内较多嗜中性粒细胞、淋巴细胞及浆细胞混合性浸润，并见上皮样细胞肉芽肿（图2）。 PAS 染色：未见菌丝及孢子结构。真菌镜检及培养：申克孢子丝菌（图3）。结合临床表现，诊断为孢子丝菌病。治疗：伊曲康唑100 mg，日2次；局部热敷。治疗2个月后，皮损明显好转，面部红色斑块颜色变暗，浸润减轻，覆少许鳞屑（图1）。
