Background The scrotum is considered as an uncommon site for tinea, hence there is a lack of knowledge about the clinical characteristics, pathogenic agents and the skin microbiome changes of tinea scrotum. Objective We sought to analyze the clinical features, pathogenic agents and skin microbiome of tinea scrotum. Methods A two-center prospective observational study was carried out in outpatient dermatology clinics in Zhejiang, China, from September 2017 to September 2019. The diagnosis of tinea scrotum was confirmed by direct microscopy. Clinical and mycological data were collected. The composition of microbial communities of patients with tinea scrotum was analyzed and compared with healthy controls. Results A total of 113 patients with tinea scrotum were included. Tinea scrotum was either presented with isolated lesions (9/113, 8.0%) or accompanied by tinea of other sites (104/113, 92.0%). Tinea cruris was detected in 101 cases (89.38%). Fungal culture was positive in 63 cases, among which Trichophyton rubrum was grown in 60 cases (95.2%) and Nannizzia gypsea was cultured in 3 cases (4.8%). The skin microbiome in scrotum lesions from 18 patients showed increased abundance of Trichophyton compared with 18 healthy individuals, while Malassezia was decreased. No significant difference in bacterial diversity was found. Conclusions Tinea scrotum was often companied by superficial fungal infections of other skin sites, with tinea cruris being the most common condition. Instead of N. gypsea , T. rubrum was the most frequently identified pathogen for tinea scrotum. In general, tinea scrotum exhibited changes in the fungal communities of the skin with increased Trichophyton and decreased Malassezia abundance.

患者男,67岁.阴茎龟头浸润性红斑10年.患者10年前发现阴茎龟头处一绿豆大红斑,逐渐增大,无自觉症状.1周前在当地医院体检时建议转我院皮肤科就诊.既往史、家族史:既往体健,家族中无类似疾病患者.皮肤科检查:尿道口周围、龟头左侧不规则浸润性片状红斑,边界清楚,表面光滑,有光泽(图1A).

患者男,58岁. 主诉:右侧肩部皮肤赘生物40年余. 现病史:患者40年前右侧肩部出现黄豆大红色丘疹,无明显不适,未治疗.后皮损逐渐增大,颜色变为暗红色,无明显痒、痛等不适,于2017年9月28日至我院皮肤科门诊就诊. 既往史及家族史:患者既往体健,无外伤史及系统性疾病史.家族中无类似疾病患者.

We report a 45-year-old woman presenting with a painful subungual epidermal cyst on the 4th finger nail bed. Based on clinical features only, the lesion was initially suspected to be a glomus tumor. However, histopathological examination revealed an epidermal cyst on the nail bed. Subungual epidermal cysts are rare disorders that may cause pain and tenderness that increase according to tumor growth. They can mimic glomus tumors owing to their similar clinical manifestations. To differentiate subungual epidermal cysts from glomus tumors, imaging tools such as ultrasonography and magnetic resonance imaging can be used. Dermatologists should be aware that several kinds of tumors including epidermal cysts with clinical similarities may occur in the subungual area.

1病历资料 患者女,59岁.因左手背水肿性红斑伴疼痛20 d,于2017年1月3日来宁波市北仑区人民医院皮肤科就诊.患者20 d前无明显诱因左手背突然出现水肿性红斑,并逐渐增大、肿胀且疼痛明显,伴发热,体温最高38.9 ℃.当地医院给予抗生素治疗(具体不详),病情无明显好转.追问病史,患者2年前和1年前均有过一类似发病史,在当地医院给予对症治疗(具体药物和剂量不详)后,皮损完全消退.

患者男,22岁.发现阴茎囊肿2年.患者2年前无意发现阴茎腹侧中上段一绿豆大囊状物,约半年后囊肿下方又出现一米粒大囊性增生,渐增大至绿豆大,2个囊肿逐渐融合沿阴茎中线蔓延,无自觉症状.既往体健,无用药史,无外伤史,否认有非婚性接触史,家族史无特殊.

患儿男,9岁.左侧颞部三角形脱发9年,于2018年8月27日来宁波市北仑区人民医院就诊.患儿出生时即发现左侧颞部三角形脱发区,无红肿,随年龄增大而增大,无自觉症状.既往体健,家族中无类似疾病患者.

目的 通过VISIA皮肤测试仪定量评估光子嫩肤对皮肤光老化的治疗效果.方法 选取32名面部皮肤患者行光子嫩肤治疗5次(每4周1次).用VISIA皮肤测试仪检测治疗前后皮肤斑点、纹理、皱纹、毛孔情况.结果 面部光老化患者经光子嫩肤治疗后,皮肤斑点、纹理、皱纹、毛孔值明显下降,差异有统计学意义(P<0.05).结论 光子嫩肤对面部皮肤光老化有显著的治疗效果,应用VISIA皮肤检测仪可以进行更加科学直观地评价.

患者,男,21岁.阴囊白色斑块伴瘙痒2周.真菌培养镜检及ITS测序为石膏样小孢子菌.外用特比萘芬乳膏,4周后皮损消退,真菌学检查阴性.

患者男,79岁.左上肢皮肤结节4个月,于2017年12月20日来宁波市北仑区人民医院就诊.患者4个月前左上肢出现一蚕豆大淡红色丘疹,并逐渐增大至热水瓶盖大,无痛痒及破溃.既往体健,有吸烟史60年(每日1包).家族中无类似疾病患者.

患者男,60岁. 主诉:阴茎肿块3个月. 现病史:患者3个月前与妻子性接触次日发现阴茎冠状沟处出现一条索状囊性肿物,无不适,勃起时肿块增大,2～3 d后肿块明显缩小,近2周冠状沟近包皮系带处出现一绿豆大硬结,不能自行消退,遂于2016年7月至我科就诊. 家族史:家族中无类似疾病患者. 既往史:既往身体健康,发育正常. 体格检查:一般情况好,系统检查未见异常.皮肤科检查:阴茎伸侧一约2.0cm×0.4 cm肤色条索状肿物,表面光滑、边界清、活动度好,近系带处一约绿豆大触之有软骨样硬度的皮下结节,周围呈囊性(图1).

患者男,65岁. 主诉:左手中指伸侧肿块1年. 现病史:患者1年前无明显诱因左手中指伸侧出现一约黄豆大结节,逐渐缓慢生长,无自觉症状.近半年来增大至花生米大.逐至我院就诊. 既往史:既往体健. 家族史:家族成员中无类似疾病患者. 皮肤科检查:左手中指伸侧皮下肿块,约花生米大,呈分叶状(图1),质地韧,无压痛,境界清楚,表皮温度正常,手指血供正常,无感觉障碍,活动自如. 皮损组织病理检查:瘤体呈分叶状,瘤细胞团块主要由片状上皮样组织细胞和多核破骨细胞样巨细胞组成(图2A、B). 诊断:腱鞘巨细胞瘤.

患儿男,6岁.因右拇指赘生物6年就诊.患儿出生时左拇指近节中段桡侧有一米粒大肤色赘生物,未予以治疗.赘生物逐渐增大至1岁时皮损增至豌豆大后停止生长,无自觉症状.患儿足月顺产,母乳喂养.平素身体健康.家族成员中无类似疾病患者.

患者男,19岁.因左侧乳头乳晕皮肤增厚伴角化过度10余年就诊.患者10余年前无明显原因于左侧乳头、乳晕处出现针头大的浅褐色小丘疹,之后皮疹逐渐扩大,局部增生肥厚,颜色加深,无自觉症状.未经治疗.否认既往皮损红肿、破溃及渗液.患者既往体健.家族成员无类似疾病家族史.

临床资料患者,男,26岁。因左面颊部红色结节半年,于2012年5月来我院就诊。患者半年前无明显诱因左面颊部出现一粟粒大丘疹,无任何不适,一直未诊治。丘疹逐渐增大至花生米大,无出血、渗液,无瘙痒和疼痛等自觉症状。既往体健,否认患处有外伤史及虫咬史,否认有家族遗传病史及类似疾病史。体格检查：一般情况良好,系统检查未见异常。皮肤科情况：左面颊部一半球形淡红色结节,直径约1.0 cm,境界清楚,表面角化,稍发亮,质地略硬,无压痛(图1)。其他部位未见类似皮损,口腔黏膜、四肢末端未见明显皮损。实验室检查：血、尿常规及肝、肾功能均未见明显异常。组织病理示：真皮内多个小叶状增生的瘤团,增生的细胞为向外毛根鞘分化的鳞状细胞,胞质淡染、苍白、无异型。肿瘤小叶外层可见基底样细胞呈栅栏状排列,肿瘤底部以淋巴细胞浸润为主(图2、3)。诊断：面部单发性外毛根鞘瘤。局麻下予手术切除肿块。术后切口愈合良好。随访至今,未见复发。

临床资料患者,女,28岁。左下腹散在丘疹5年。5年前发现左下腹散在丘疹有光泽,米粒大,无痛不痒、边界清楚,无红肿及皮肤溃烂,未作治疗,近年来皮损逐渐增多,无任何不适,于2012年2月就诊本院。体格检查：一般情况好,浅表淋巴结无肿大,心肺(-),腹平软,肝脾未及肿大。皮肤科情况：左下腹散在丘疹有光泽,米粒大,边界清楚,最大丘疹周围呈卫星状分布细小丘疹,无红肿及皮肤溃烂,皮肤皮纹正常(图1)。辅助检查：血尿常规正常,肝肾功能正常,癌胚抗原1.66 ng/mL。组织病理检查示：鳞状上皮乳头状增生,表面角化过度伴角化不全,上皮角延长,表皮内、真皮乳头区及真皮浅层见多量血管增生,血管弯曲,大小不一,扩张明显,间质少量淋巴细胞浸润(图2)。病理诊断：血管角化瘤。行二氧化碳激光治疗,随访1年无复发。

临床资料患者,女,94岁。右面部疣状赘生物6年余,伴轻度疼痛1年。患者6年前无意中发现右侧颊部米粒大新生物,无瘙痒、疼痛不适,当时未予重视及治疗。多年来新生物渐增大,无疼痛。1年前无明显诱因新生物出现间断性针刺样疼痛,其表面有破溃,多次去当地医院就诊,诊断不明,外用百多邦软膏无明显效果,皮损渐增大。无特殊家族病史,发现“高血压病”10年；“冠状动脉粥样硬化性心脏病”2个月。体检：一般情况好,浅表淋巴结未触及肿大,系统检查未发现明显异常。

Objective: To assess the therapeutic efficacy of compound betamethasone injection combined with local injection with 5% imiquimod cream in the treatment of keloid. Methods:The patients were random-ly divided into two groups. The treatment group was given intralesional compound betamethasone, once every 3 weeks for 3 times, combined with topical daily 5% imiquimod cream for 3 months. The control group only re-ceived compound betamethasone intralesional injection. The clinical efficacy and side effects were assessed af-ter 6 months. Results:The effective rates in the treatment and control group were 93.55% and 70.37%, re-spectively, with a significant difference. The recurrence rate was lower in the treatment group than in the con-trol group, with a significant difference. The side effects were mild. Conclusion:Compound betamethasone in-jection combined with 5% imiquimod cream is safe and effective in the treatment of keloid.

1 临床资料 患者女,65岁.因外阴白斑伴痛痒10年,躯干白斑6个月就诊.患者10年前无明显诱因于外阴部出现白斑伴疼痛、瘙痒,渐增多扩大,曾在当地医院诊断“外阴瘙痒症、外阴白斑”短期治疗(具体用药不详),无明显效果.6个月前腰背部及乳房出现瓷白色斑丘疹,无不适,渐增多.既往体健,否认有外伤史,否认有家族遗传病史及类似疾病史.体格检查:一般情况良好,系统检查未见异常.

目的 观察Axl(Aexekleto)、真核转录因子-κB[NF-κB(P65)]在正常皮肤组织和皮肤鳞状细胞癌(SCC)组织中的表达情况及特点,并探讨其在皮肤SCC发生发展中可能的意义.方法 采用免疫组化SABC法检测20例正常皮肤组织及40例皮肤SCC中Axl、NF-κB(P65)的表达.结果 Axl在皮肤SCC组织和正常皮肤组织中的阳性表达率分别是87.5%和0%,两者相比差异有统计学意义(χ2=42.0,P＜0.05).NF-κB(P65)在皮肤SCC组织和正常皮肤组织中阳性表达率分别为82.5%和10.0%,两者相比差异有统计学意义(χ2=28.83,P＜0.05).Axl及NF-κB(P65)在皮肤SCC中的表达等级相关系数rs=0.224,P=0.165,差异无统计学意义.结论 Axl介导的信号通路可能在皮肤SCC的发生发展过程中发挥一定的作用.