Objective To explore the clinical efficacy and safety of electro-hydrodynamic droplet injection of botulinum toxin type A(BTX-A)for the treatment of erythematotelangiectatic rosacea(ETR).Methods Twenty-seven females with ETR were treated with electro-hydrody-namic droplet injection of BTX-A at the Department of Dermatology and Cosmetology,the Second People's Hospital of Bijie City.The cumulative dose of unilateral face was 20-30 U,and 40-60 U per patient.Clinical erythema score,dermatology life quality index(DLQI),symptom and sign score,and adverse reactions were assessed before and 8 weeks after the treatment.Results All 27 patients completed the study.Patients showed significant improvements in the clinical erythema score(from 2.67±0.83 to 1.30±0.60,t=10.54,P＜0.001),DLQI(from 14.96±5.50 to 6.52±2.79,t=9.38,P＜0.001)8 weeks after the treatment.Similarly,the facial skin burning score,dryness score,itching score,flushing score,and edema score were also significantly de-creased(all P＜0.01 vs.baseline).However,the score of facial capillary dilation did not change significantly(P=0.1).No significant adverse reactions,such as pain,local bruising,facial mus-cle paralysis,or unnatural expressions,were observed.Conclusions Electro-hydrodynamic droplet injection of BTX-A is safe and effective for improving the symptoms such as erythema,burning,dry-ness,itching,flushing and edema,and quality of life in ETR patients.

报告1例罕见头皮小汗腺痣合并乳头状汗管囊腺瘤.患者男,78岁,出生时即发现头皮黄豆大小肿物.皮肤科检查:头皮顶部可见一肤色及玫瑰红色斑块.皮损组织病理检查示:部分表皮呈疣状增生,真皮深层可见大量结构正常的小汗腺腺体及导管;另一部分表皮向真皮凹陷形成囊状腔,囊状腔下部可见乳头状突起,乳头状突起由两排细胞组成,乳头状突起基质内可见较多浆细胞.诊断:头皮小汗腺痣合并乳头状汗管囊腺瘤.予手术切除皮损及皮瓣修复术.术后18个月电话随访无复发.

目的 观察CO2点阵激光联合重组人表皮生长因子凝胶(Recombinant human epidermal growth factor,rhEGF)治疗面部凹陷性痤疮瘢痕的疗效及不良反应.方法 收集凹陷性痤疮瘢痕患者34例,试验组采用CO2点阵激光治疗后外用rhEGF均匀涂抹于创面,术后严格防晒.对照组外用生理盐水涂抹,其余治疗、护理等均与实验组相同.治疗3次后观察治疗效果.结果 试验组总有效率(91.2％)略高于对照组(85.3％),差异无统计学意义(P>0.05).试验组ECCA评分明显高于对照组,差异有统计学意义(P<0.05).试验组疼痛评分与对照组相当,差异无统计学意义(P>0.05).结痂持续时间、红斑持续时间、皮肤角质层含水量及不良反应发生率,试验组均优于对照组,差异有统计学意义(P<0.05).结论 CO2点阵激光联合rhEGF治疗面部凹陷性痤疮瘢痕可减少术后不良反应的发生,增加治疗效果,提高患者满意度.

1 临床资料 患者,女,4岁,发现外阴赘生物2周.2周前患者母亲无意中发现患儿外阴出现数个米粒大小赘生物,无疼痛、破溃;未予重视,未作特殊处理,后感赘生物逐渐增多、增大延至肛周,既往无外伤史,无皮炎、湿疹史,无家族遗传史,否认内分泌疾病史.其父既往有冶游史,有梅毒及尖锐湿疣病史,其母否认患有此病;患儿姐姐及弟弟均未患有此病.患儿常与其父同睡,其父常帮助患儿大小便.

1临床资料 患者,男,79岁,全身白斑20年,红斑鳞屑伴痒1年.20年前患者无明显诱因,头皮、躯干出现白斑,边界清楚,无瘙痒及疼痛,初起未予重视,后皮损渐进性增多,自行外用药物未见缓解,1年前躯干出现红斑、鳞屑,伴明显瘙痒,曾就诊于当地医院,诊断“白癜风、银屑病”,予药物(具体不详)治疗后未见缓解,发病来无咳嗽、咳痰、头晕、头痛、腹痛、腹泻等症状,今日为进一步诊治就诊我科.既往无外伤史,无皮炎、湿疹史,无鱼鳞病史,无家族遗传史,否认内分泌疾病史.

报道成人左颈前部副耳1例.患者女,31岁,左颈前部渐大性皮肤赘生物31年.查体:左侧颈前部可见单发绿豆大小肤白色椭圆形球状结节,质地中等,表面光滑伴毛发生长,深部可触及条索状结构,呈软骨样硬度,结节位于左侧胸锁乳突肌前缘线上,挤压无分泌物.外耳道、支气管未见异常.组织病理:表皮及部分真皮缺如,真皮正常,皮下可见完整软骨结构.诊断:副耳.治疗:手术完整切除.术后2个月恢复良好,至今未见复发.

日光性黑子(solar lentigo, SL)也称为日光性雀斑样痣、老年性色素斑或老年性黑子.多见于面部、手背以及前臂等日光暴露部位,呈圆形、椭圆形或不规则形棕褐色色素斑,为中老年人皮肤老化的一种表现.病因未完全阐明,过去认为主要与日光暴露有关,但近期一系列流行病学及机理研究表明,除外日光暴露,皮肤类型、环境空气污染、吸烟以及激素治疗等因素也参与SL样皮损的形成.SL虽为良性色素斑,但其可影响美观,对患者生活质量存在消极影响.近年来,随着人们对美观要求的提高,临床上就诊的SL患者越来越多,而国内外对此病仍缺乏认识.因此,本文利用现有的证据总结除日光暴露以外的其他因素在SL发病中的作用,以期为本病的临床诊断及预防提供参考.