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	Chinese Journal of Dermatology
	2010 Vol.43 No.8
	Published 2010-08-15

	Expert Forum Brief Reports Case Reports

Original articles

	523
		Rapid identification of eight pathogenic filamentous fungi with PCR-RFLP analysis
		Objective To develop a PCR-RFLP method to rapidly identify filamentous fungi causing deep infection. Methods Universal fungal primers were used to amplify the internal transcribed spacer （ITS） region of Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus, Aspergillus niger, Aspergillus versicolor, Aspergillus nidulans, Scedosporium apiospermum and Fusarium moniliforme followed by restriction fragment length polymorphism （RFLP） analysis with restrictive endonucleases Hha I, Hae III, Hinf I, Taq I and Msp I. Then, 22 clinical and 2 environmental fungal isolates were identified with the developed PCR-RFLP method. Results The RFLP analysis of PCR products with restrictive endonucleases Hha I and Hinf I allowed discrimination of 8 filamentous fungi causing invasive infection, and it took only 1 day to carry out the whole procedure from DNA extraction to PCR and restriction digestion. The identification results of 22 clinical strains and 2 environmental isolates with this PCR-RFLP method were completely consistent with those with conventional morphological method. Conclusion PCR-RFLP analysis is an efficient method for rapid identification of cultured filamentous fungi.
		2010 Vol. 43 (8): 523-525 [Abstract] ( 43 ) [HTML 0KB] [PDF 0KB] ( 5 )

	526
		Cutaneous infection caused by Trichosporon dermatis: first case report in China
		Objective To report a case of cutaneous infection due to Trichosporon dermatis. Methods Lesional discharge and tissue were obtained and subjected to microscopic examination, fungal culture and histopathology, respectively. The fungal isolate was then identified with DNA sequence analysis, API 20C AUX system, gelatin liquefaction test, thermal tolerance test. Antifungal susceptibility test was also performed for the fungus. Results A 70-year-old male presented with a 9-month history of ulcerated swelling of the right medial malleolus after plant puncture. Direct microscopic examination of lesional discharge showed no fungal elements, but histopathological biopsy revealed hyphae and spores in the dermis. Yellowish white yeast-like colony grew on Sabouraud dextrose agar （SDA）. Slide culture showed pseudohyphae, true hyphae, arthroconidia and blastoconidia. The isolate was identified as Candida humicola by API 20C AUX system, but as T. dermatis by DNA sequence analysis. The strain was unable to liquefy gelatin, could grow at 25 ℃ to 40 ℃, and was sensitive to amphotericin B, itraconazole, voriconazole and nystatin. The skin lesion completely subsided after 4-month treatment with oral itraconazole. Conclusions The isolate is identified as T. dermatis according to morphological features and DNA sequence, which is sensitive to itraconazole.
		2010 Vol. 43 (8): 526-528 [Abstract] ( 28 ) [HTML 0KB] [PDF 0KB] ( 2 )

	529
		Detection of TAC1 gene point mutations in fluconazole-resistant Candida albicans isolates with rolling circle amplification
		Objective To detect point mutations of TAC1 gene in fluconazole-resistant Candida albicans isolates with rolling circle amplification （RCA）, develop an accurate, rapid and specific assay to detect single nucleotide polymorphisms （SNPs）, and to estimate the relationship between mutations of TAC1 gene and resistance to fluconazole. Methods A total of 33 fluconazole-resistant Candida albicans isolates, including 8 strains from America and 25 from Australia, were collected. Four TAC1-specific padlock probes were designed according to previously reported mutations. DNA was extracted from these tested strains, subjected to amplification of three targeted fragments of TAC1 gene with PCR. Then, RCA was performed to detect point mutations of TAC1 gene in resistant Candida albicans strains. At the same time, the target fragments underwent sequencing analysis, and the results of RCA were compared with those of sequencing. Results Two types of resistance-associated mutations were found in 5 out of the 33 fluconazole-resistant strains. Among the 5 strains, 4 were from America, 1 harbored T225A mutation and 4 carried A736V mutation. No related mutation was found in TAC1 gene of 4 fluconazole-sensitive isolates. Conclusions RCA assay could accurately and rapidly detect point mutations of genes. Further studies are required to clarify the relationship between TAC1 point mutations and fluconazole resistance.
		2010 Vol. 43 (8): 529-533 [Abstract] ( 23 ) [HTML 0KB] [PDF 0KB] ( 0 )

	534
		Primary exploration on identification of pathogenic Trichosporon spp. with rDNA-RFLP analysis
		Objective To genotype Trichosporon spp. with rDNA-ITS/IGS1-RFLP analysis followed by cluster analysis, and attempt to apply this method to rapid species identification of human pathogenic Trichosporon spp.. Methods Fourteen strains of Trichosporon, which belonged to 8 species, were collected. The rDNA-ITS/IGS1 regions were amplified by PCR and sequenced. Simultaneously, the amplicons were digested separately with restriction enzymes, including HaeⅢ, HhaⅠ, HaeⅢ and HhaⅠ, HinfⅠ, MspⅠ and TaqⅠ. Results The 8 species of Trichosporon could be classified into 4 subgroups with rDNA-ITS-RFLP, while interspecies identification of all the 14 strains from 8 species of Trichosporon could be realized with rDNA-IGS1-RFLP. Also, those genotypes of T. asahii which had relative long phylogenic distance could even be discriminated with rDNA-IGS1-RFLP. Conclusion The rDNA-ITS/IGS1-RFLP analysis is expected to be used in rapid interspecific identification of genus Trichosporon.
		2010 Vol. 43 (8): 534-537 [Abstract] ( 21 ) [HTML 0KB] [PDF 0KB] ( 0 )

	538
		Study of biofilm formation by Trichosporon asahii
		Objective To observe morphological characteristics and activity distribution of T. asahii biofilm. Methods The morphological characteristics of T. asahii biofilm were observed under an inverted microscope and scanning electron microscope, and activity was measured and quantitatively analyzed by 2,3-bis （2-methoxy-4-nitro-5-sulfophenyl）-5-［（phenylamino） carbonyl］-2H-tetrazo-lium hydroxide （XTT） assay and viable count, respectively. Spatial distribution of dead/vital cells, activity and thickness of biofilm at different layers were assessed under a confocal laser scanning microscope （CLSM） following double staining with FDA/PI. Results T. asahii formed a biofilm in vitro on the surface of polystyrene materials. Under a scanning microscope, the biofilm displayed a complex three-dimensional structure which composed of spores, pseudohypha and true hypha. As time prolonged, the activity and quantity of biofilm increased. The results of XTT assay were correlated with those of viable count （r = 0.94, P < 0.01）. The activity was of no obvious difference between different layers of the biofilm. The thickness of biofilm varied from 14.3 μm to 31 μm. Conclusions The structure of T. asahii biofilm in vitro is more complex than that of planktonic T. asahii. The activity is of no significant difference between different layers of T. asahii biofilm.
		2010 Vol. 43 (8): 538-541 [Abstract] ( 43 ) [HTML 1KB] [PDF 0KB] ( 1 )

	542
		DNA sequence homology analysis of Trichophyton rubrum isolates from multiple body sites of patients with onychomycosis
		Objective To profile genotypes of Trichophyton rubrum isolates from different body sites in patients with onychomycosis. Methods DNA was extracted from 30 T. rubrum isolates from 10 patients with onychomycosis, and subjected to PCR with tandemly repetitive subelement 1 （TRS1）-specific primer to analyze the number of repetitive elements in the non-transcribed spacer （NTS） region of ribosomal DNA gene, and to random primer amplification with the random primer OPAA11. The genotype variety was evaluated for T. rubrum isolates from different body sites of patients with onychomycosis. Results All the strains were classified into 5 genotypes based on the copy number of TRS1, and into 11 genotypes by RAPD analysis. The genotypes of T. rubrum seemed unrelated to sites of infection. Genotype diversity was observed among T. rubrum strains from different body sites of the same host in 7 out of the 10 cases as shown by amplification of TRS1 region, in 8 out of the 10 cases as demonstrated by RAPD analysis. Conclusion A single host with onychomycosis could harbor multiple genotypes of T. rubrum at different body sites, suggesting external sources of infection rather than infection from a different site in the same individual.
		2010 Vol. 43 (8): 542-545 [Abstract] ( 23 ) [HTML 0KB] [PDF 0KB] ( 0 )

	546
		Black-dot ringworm caused by Trichophyton tonsurans and analysis of its extracellular enzymatic activity
		Objective　To report a case of black-dot ringworm caused by Trichophyton tonsurans in a 3-year-old girl. Methods　Lesional hair was obtained from the patient and subjected to direct microscopic examination as well as culture. Subsequently, the isolate underwent morphological, biochemical and molecular biology identification. The extracellular enzymatic activity of the isolate was analyzed. Results　Microscopy revealed that the hair shaft was filled with fungal spores. Typical colony of the isolate was grayish-white with downy appearance. Slide culture showed centipede-like, lateral, rod-shaped microconidia. Urease test was positive. The amplification of ribosomal DNA （rDNA） ITS domains by PCR produced a 687 bp-sized fragment which had a 100% homology with the sequences of several Trichophyton tonsurans strains in the GenBank database. The extracellular enzymatic activity analysis showed an increase in the activity of alkaline phosphatase, acid phosphatase, esterase （C4）, β-glucosidase, leucine arylamidase, N-acetyl-β-glucosaminidase and α-mannosidase. Conclusions　The pathogenic fungus is identified as Trichophyton tonsurans based on morphological and biochemical features as well as sequence of the ITS region of rDNA, and the child was diagnosed with black-dot ringworm.
		2010 Vol. 43 (8): 546-548 [Abstract] ( 26 ) [HTML 0KB] [PDF 0KB] ( 2 )

	549
		Clinical, histopathologic and ultrastructural characteristics of achromic naevus
		Objective To study the clinical, histopathologic and ultrastructural characteristics of achromic naevus （AN）. Methods Clinical data, including sex, age, age of onset, pattern of lesions, involved sites, shape and number of lesions and associated systemic diseases, were collected from 85 patients with AN. Skin melanin index was detected in 34 lesions of 19 patients with AN, 30 lesions of 12 patients with vitiligo and 64 contralateral normal skin islands of the 31 patients. Reflectance confocal microscopy （RCM） was performed to analyze the lesion, normal skin and junctional area between lesional and normal skin of 62 patients with AN. Tissue samples were obtained from lesions and perilesional normal skin of 17 patients with AN and subjected to pathological examination as well as ultrastructural study with transmission electron microscopy; also, skin biopsy specimens were immunostained for tyrosinase, HMB45, tyrosinase-related protein-1 （TRP-1）, TRP-2 and CD117. Results Of the 85 patients with AN, 23 （27.1%） developed lesions at birth, and 21 （24.7%） after 3 years of age; 72 （84.7%） had irregularly shaped lesions, 54 （63.5%） had only a single lesion. The mean melanin index and relative melanin index of AN lesions were 186.56 ± 52.86 and 80 ± 11, respectively, significantly lower than those in normal skin islands （223.88 ± 63.19 and 100, both P < 0.01）, but higher than those in depigmented lesions from 12 patients with vitiligo （128.57 ± 64.31 and 60 ± 20, both P < 0.01）. RCM revealed a decline in the number of melanocytes and brightness of melanin caps, even distribution of melanin in lesions, as well as obscure demarcation between lesions and normal skin from patients with AN. Fontana-Masson stain showed that the melanin content was lower in lesions than in perilesional skin （1810.12 ± 327.96 vs 2064.24 ± 260.41） from patients with AN. Microscopic examination demonstrated a decrease in melanocyte and melanosome number, presence of immature melanocytes at stage Ⅱ and Ⅲ in cytoplasm and dendrites of melanocytes and keratinocytes, aggregated melanosomes in affected keratinocytes in lesions of AN. In 17 patients with AN, the relative expression levels of tyrosinase and TRP-1 were 1827.35 ± 307.09 and 6102.54 ± 1642.64, respectively, in normal skin specimens, significantly higher than those in lesional skin （1477.35 ± 224.05, 5322.33 ± 1565.26, both P < 0.01）; no statistical difference was observed in the expression levels of HMB45, TRP-2 or CD117 between lesional and normal skin. Conclusions AN is an early-onset, nonfamilial aggregated, stable leukoderma with irregular margins, and in lesions of AN, the number of both melanocytes and melanosomes is decreased with the presence of immature melanosomes. The measurement of relative melanin index and reflectance confocal microscopy may offer a non-invasive approach to the diagnosis of AN.
		2010 Vol. 43 (8): 549-554 [Abstract] ( 24 ) [HTML 0KB] [PDF 0KB] ( 0 )

	555
		A case of blastic plasmacytoid dendritic cell neoplasm
		A 51-year-old man presented with multiple, disseminated dark erythematous maculopapules and nodules over the body surface for more than 1 year. Initially, the patient presented with dark erythematous macules on the trunk without discomfort. Then, lesions gradually spread over the whole body surface with the development of tenderness. Physical examination revealed multiple disseminated dark erythematous, well-demarcated maculopapules, infiltrative plaques and subcutaneous nodules on the face, neck, trunk, upper and lower limbs. Some lesions were tender on palpation. An enlarged cherry-like lymph node was detected on the right inguina. Bone marrow inspiration showed that lymphocytes amounted to 32.5%, and naive lymphocytes accounted for 10%. These lymphocytes varied in size with irregular shape, moderate amount of basophilic cytoplasm, irregular nuclei and granular chromatin. Histopathological examination revealed diffuse infiltrate of numerous medium-sized atypical blastic cells with irregular nuclei in superficial dermis and subcutaneous fat tissue. The blastic cells showed sparse fine-granular chromatin, obscure nucleoli and obvious karyokinesis. Immunophenotype examination showed that tumor cells were strongly positive for CD4, CD56 and CD43, weakly positive for CD68 and terminal deoxynucleotidyl transferase, but negative for L26, CD3, CD38, granzyme B and myeloperoxidase. The diagnosis of BPDCN is confirmed based on typical clinical features, histopathology and immunohistology findings.
		2010 Vol. 43 (8): 555-557 [Abstract] ( 25 ) [HTML 0KB] [PDF 0KB] ( 0 )

	558
		Phenotype, genotype and ultrastructural findings in a pedigree with autosomal recessive congenital ichthyosis
		Objective To investigate the clinical phenotype, genotype and ultrastructural features in a pedigree with autosomal recessive congenital ichthyosis. Methods Patients were examined for clinical manifestation. PCR was carried out to amplify all the 15 exons and adjacent splice sites of TGM1 gene followed by bidirectional sequencing. Skin samples were taken by biopsy from the back of the proband, fixed in 3% glutaraldehyde for transmission electron microscopy. Results The proband presented an intermediate clinical phenotype between lamellar ichthyosis （LI） and non-bullous congenital ichthyosiform erythroderma （NCIE）, while his brother manifested as a collodion baby. A C551T heterozygous mutation which located in the third exon of TGM1 gene and resulted in a substitution of arginine by cysteine at codon 143 （R143C）, was detected in the proband, his brother and father. Meanwhile, another heterozygous C-to-T transition at position 759 causing a substitution of serine by phenylalanine at codon 212 （S212F）, was noted in the proband, his brother and mother. Electron microscopy revealed not only features of ichthyosis congenital type Ⅲ but also those of ichthyosis congenital type Ⅱ in lesions of the proband. Conclusions The patients in this pedigree carry compound heterozygous mutations, i.e. R143C, a hot missense mutation, as well as a de novo mutation S212F. The proband, who harbors mutations in the TGM1 gene, shows electron microscopic features characteristic not only of ichthyosis congenital type Ⅱ but also of ichthyosis congenital type Ⅲ.
		2010 Vol. 43 (8): 558-561 [Abstract] ( 24 ) [HTML 0KB] [PDF 0KB] ( 0 )

	562
		Relationship between human papillomavirus and extragenital Bowen′s disease
		Objective To assess the relationship between human papillomavirus （HPV） and extragenital Bowen′s disease. Methods Regular PCR with consensus primers for L1 region as well as mix primers and nested PCR were performed to detect the DNA of a broad range of cutaneous and mucosal HPV types in tissue samples from lesions of 41 patients with extragenital Bowen′s disease and from normal skin of 48 human controls. Semiquantitative PCR and tyramide-based in situ hybridization （ISH） were also conducted to determine the load and localization of HPV DNA in HPV-positive samples. Results HPV DNA was detected in lesions from 5 （12%） of the 41 patients with extragenital Bowen′s disease. Of the 5 HPV-positive patients, 3 carried mucosal HPV types （HPV16 in 2 cases, HPV 33 in 1 case） with a viral load of 101 to 103 copies, 2 cutaneous HPV types （HPV27 in 1 case and HPV76 in 1 case）. As ISH showed, there was a generalized expression of mucosal HPV DNA in most tumor cell nuclei but not in peritumoral normal tissue, and no expression of cutaneous HPV DNA was observed in lesions. HPV DNA was detected in 1 （2.1%） control tissue sample, which proved to be epidermodysplasia verruciformis-associated HPV23. There was no significant difference in the detection rate of HPV DNA between the patients and controls. The viral load of cutaneous HPV types amounted to 10-2 to 10-3 copies in the 2 patients, which was similar to that of HPV 23 in the normal control. Conclusion Mucosal HPV types may be closely associated with the development of extragenital Bowen′s disease.
		2010 Vol. 43 (8): 562-564 [Abstract] ( 28 ) [HTML 0KB] [PDF 0KB] ( 0 )

	565
		Clinical efficacy of plasma exchange in 47 patients with severe bullous dermatoses or drug eruption
		Objective To estimate the therapeutic value of plasma exchange （PE） in severe bullous dermatoses and drug eruption. Methods Plasma exchange was carried out to treat 47 patients with severe dermatoses including 15 cases of pemphigus, 17 cases of bullous pemphigoid and 15 cases of drug eruption who were intolerant or unresponsive to glucocorticosteroids and or immunosuppressants. Cobe Spectra blood cell separator was utilized to collect plasma and cell components from patients′ blood, and the replacement fluid and cell components were infused back into patients. Patients received 1 to 3 sessions of plasma exchange. Results Of the 47 patients, 44 （93.62%） achieved satisfactory efficacy with relief of clinical symptoms and improvement of laboratory parameters 2 to 3 days after the plasma exchange. Side effects occurred in 11 （23.4%） patients, which included fever, shivering, numbness of limbs, pruritus and convulsion. Conclusion Plasma exchange is beneficial for the control of severe drug eruption and bullous dermatoses.
		2010 Vol. 43 (8): 565-567 [Abstract] ( 25 ) [HTML 0KB] [PDF 0KB] ( 0 )

	568
		Cloning, expression, purification and identification of Chlamydia trachomatis polymorphic membrane protein G
		Objective To clone, express and purify Chlamydia trachomatis polymorphic membrane protein （Pmp G）, and to identify its immunogenicity. Methods The Pmp G gene of C. trachomatis serotype E was amplified by PCR, cloned into prokaryotic expression vector PET30a（+）. The positive recombinant was transformed into the bacterium E. coli （BL-21）, identified by enzyme digestion, PCR amplification and gene sequencing. Then, it was induced to express followed by the identification of expression product with SDS-PAGE and Western blotting. The purified protein was used to immunize BALB/C mice to test its immunogenicity. Results PCR produced a 1092 bp-sized DNA fragment, which had a sequence consistent with that of PmpG gene of C. trachomatis E type in the GenBank database. The molecular weight of expression product was 55 kD, which was proved to be the expected size, and Western Blotting confirmed it to be the specific protein. Moreover, special antibodies to PmpG were induced to be generated by mice immunized with the purified protein. Conclusions The constructed prokaryotic expression vector for PmpG is expressed successfully in E. coli, and the expression product shows immunogenicity.
		2010 Vol. 43 (8): 568-571 [Abstract] ( 23 ) [HTML 0KB] [PDF 0KB] ( 0 )

	572
		Autophagy in human skin fibroblast model for photoaging
		Objective To observe the changes of autophagy in human skin fibroblast （HSF） model for photoaging. Methods HSF model for photoaging was established through repeated exposure to ultraviolet B （UVB）. Those HSFs receiving no irradiation served as the control. The degree of aging was evaluated by β-galactosidase assay, and autophagy level was detected. Results After repeated exposure to UVB, most photoaged HSFs were deformed and distorted, and some of them even died. The percentage of β-galactosidase-positive cells was 50.60% ± 5.04% and 14.58% ± 2.69%, respectively in photoaged and control HSFs （P ＜ 0.01）. Significant difference was also observed in the proportion of cytophagosome-positive cells between photoaged and control HSFs （14.91% ± 4.59% vs 68.45% ± 8.25%, P ＜ 0.01）. Conclusion The HSF model for photoaging shows obviously abnormal appearance and stagnant growth with increased degree of senescence and decreased autophagy compared with normal control HSFs.
		2010 Vol. 43 (8): 572-574 [Abstract] ( 24 ) [HTML 0KB] [PDF 0KB] ( 0 )

	575
		Effect of microRNA-let-7a on apoptosis in melanoma cell line A375
		Objective To investigate the effect of microRNA-let-7a on apoptosis in melanoma cell line A375 and its mechanism. Methods The expression of microRNA-let-7a was detected in A375 cells and melanocytes by real-time PCR. Then, microRNA-let-7a mimics was transfected into A375 cells followed by the measurement of apoptosis and caspase-3 protein expression by flow cytometry and Western blotting, respectively. Results The expression level of microRNA-let-7a was reduced by 0.462 folds in A375 cells compared with melanocytes. The apoptosis rate was 47.4% in A375 cells transfected with microRNA-let-7a mimics, significantly higher than that in untransfected A375 cells （16.9%）. A significant decline was observed in the expression of caspase-3 protein in A375 cells after transfection. Conclusion microRNA-let-7a can promote the apoptosis and downregulate caspase-3 protein expression, in A375 human malignant melanoma cells.
		2010 Vol. 43 (8): 575-578 [Abstract] ( 22 ) [HTML 0KB] [PDF 0KB] ( 0 )

	579
		Effects of substance P on nitric oxide synthesis in HaCaT cells
		Objective To observe the effects of substance P （SP）, NK1 receptor antagonist and nitric oxide synthase （NOS） inhibitors on the secretion of nitric oxide （NO） and expression of inducible NOS （iNOS） by immortalized human keratinocyte line HaCaT. Methods The NO level in supernatant of cultured HaCaT cells was measured by nitrate reductase assay after treatment with different concentrations （10-9 to 10-6 mol/L） of SP, or the combination of SP （10-8 mol/L） and spantide （3 × 10-7 mol/L）, aminoguanidine （10-7 mol/L）, 7-nitroindazole （10-6 mol/L） or L-NAME （10-5 mol/L） for various durations. Reverse transcription-PCR was performed to measure the expression of iNOS mRNA in HaCaT cells incubated with SP of 10-8 mol/L for 1, 24 and 48 hours. Results The SP of 10-9 to 10-6 mol/L significantly induced the production of NO by HaCaT cells, and the highest level of NO was observed in HaCaT cells treated with SP of 10-8 mol/L. The synthesis of NO by HaCaT cells induced by SP was inhibited by Spantide of 3 × 10-7 mol/L at all time points （30 minutes, 1, 3, 6, 12, 24 hours, all P < 0.01）, by L-NAME of 10-5 mol/L at 3 time points （30 minutes, 1, 24 hours） and by 7-nitroindazole of 10-6 mol/L at 2 time points （30 minutes, 1 hour, both P < 0.05）, but not by aminoguanidine of 10-7 mol/L at any time point （all P > 0.05）. After treatment with SP of 10-8 mol/L, the relative mRNA expression of iNOS was 0.199 ± 0.018 and 0.516 ± 0.030 at 24 and 48 hours, respectively, and there was a statistical difference between the two time points （P < 0.01）. Conclusions SP can reinforce the secretion of NO by HaCaT cells via NK1 receptor activation, but iNOS is unlikely to be the primary origin of NO secreted by HaCaT cells induced by SP.
		2010 Vol. 43 (8): 579-582 [Abstract] ( 13 ) [HTML 0KB] [PDF 0KB] ( 0 )

	583
		Effect of bacille calmette-guerin polysaccharide nucleic acid （BCG-PSN） on the expression of T cell-derived cytokines in patients with atopic dermatitis
		Objective To assess the changes in frequency of peripheral T lymphocytes expressing different cytokines in patients with atopic dermatitis （AD） before and after treatment with BCG-PSN and their relationship with disease severity. Methods A randomized, double blinded and placebo cross-over control study was conducted. A total of 8 patients with AD were recruited in this study. Intramuscular BCG-PSN or placebo was given to patients every other day for 36 days. Flow cytometry was performed to measure the frequency of IL4-, IL5-, IFNγ- and TNFα-expressing peripheral CD4+ T cells and CD8+ T cells before and after the therapy. Disease severity was evaluated by atopic dermatitis area and severity index score （ADASIS）. Results The difference value in IFN-γ+CD8+ T cell frequency before and after therapy was significantly higher in patients treated with BCG-PSN than in those with placebo （8.056 ± 13.962 vs -6.549 ± 10.491, U = 2.26, P < 0.05）. There was no statistical difference in the frequency of IL4-, IL5-, TNFα-expressing CD8+ T cells between BCG-PSN- and placebo-treated patients （all P > 0.05）. The decrease in ADASIS was 1.56 ± 1.49 in patients treated with BCG-PSN, which was statistically higher than that in placebo-treated patients （-0.05 ± 1.54, U = 2.00, P < 0.05）. Conclusion As an immunomodulator, BCG-PSN may control AD by restoring the balance of T-cell subsets.
		2010 Vol. 43 (8): 583-585 [Abstract] ( 31 ) [HTML 0KB] [PDF 0KB] ( 0 )

Case reports

	533
		A case of erythema induratum

		2010 Vol. 43 (8): 533-533 [Abstract] ( 21 ) [HTML 0KB] [PDF 0KB] ( 0 )

	545
		A case of epidermolysis bullosa-like eruptions due to detoxification treatment with subcutaneous implantation of naltrexone hydrochloride

		2010 Vol. 43 (8): 545-545 [Abstract] ( 20 ) [HTML 0KB] [PDF 0KB] ( 0 )

	554
		A case of cutaneous infection secondary to nail extraction
		Abstract: A 61-year-old man, presented with irregular verrucous plaque overlying crusting and erosions on both big toes after nails had been pulled out 1 years ago . Pus swab and biopsy for culture sensitivity showed Enterococcus faecalis. Biopsy showed pseudoepitheliomatous hyperplasia with abscess. He fulfilled criteria for the diagnosis of blastomycosis-like pyoderma viz. presentation of large verrucous plaques with pustules and elevated border, pseudoepitheliomatous hyperplasia with abscess histologically and growth of one pathogenic bacterium on culture or tissue biopsy. He responded to long-term systemic antibiotic therapy.
		2010 Vol. 43 (8): 554-554 [Abstract] ( 22 ) [HTML 0KB] [PDF 0KB] ( 0 )

	561
		A case of median nail dystrophy

		2010 Vol. 43 (8): 561-561 [Abstract] ( 18 ) [HTML 0KB] [PDF 0KB] ( 0 )

	567
		A case of ichthyosis linearis circumflexa
		A case of ichthyosis linearis circumflera is reported. The patient’s clinical feature presented as widespread annular and multi-annular erythema with scale of his trunk and proximal limbs.
		2010 Vol. 43 (8): 567-567 [Abstract] ( 20 ) [HTML 0KB] [PDF 0KB] ( 0 )

	578
		A case of hemangioma-like eccrine poroma

		2010 Vol. 43 (8): 578-578 [Abstract] ( 19 ) [HTML 0KB] [PDF 0KB] ( 0 )

	582
		A case of scleredema adultorum

		2010 Vol. 43 (8): 582-582 [Abstract] ( 20 ) [HTML 0KB] [PDF 0KB] ( 0 )

	588
		A case of giant trichilemmal carcinoma

		2010 Vol. 43 (8): 588-588 [Abstract] ( 22 ) [HTML 0KB] [PDF 0KB] ( 0 )

Brief reports

	586
		Sporotrichosis of the nose: clinical analysis of 36 cases

		2010 Vol. 43 (8): 586-587 [Abstract] ( 26 ) [HTML 0KB] [PDF 0KB] ( 0 )

	587
		Eccrine angiomatous hamartoma in children: 13 case report
		Abstract Purpose To study the clinical and pathological features of pediatric eccrine angiomatous hamartoma. Methods The clinical data were collected. The biospy tissues were routinely processed and hematoxylin-exosin staining and immunohistochemistry staining were reviewed microscopically. Results The age of 13 eccrine angiomatous hamartoma was from 2 months to 13 years old (median 5 years old). 7 cases were males and 6 females. 8 cases were congenital lesions. All of 13 cases located in extremities, including 4 cases of finger and palm, 3 foot, 1 arm, 2 knee. All cases occur as macules, plaques or nodules, including 9 cases of single lesion and 4 cases of multiple lesions. Enlargement occurred in All cases and was in concordance with the growth of the patients. The symptoms associated with 13 cases were tenderness (3 cases) and hyperhidrosis (2 cases). Histologically, 13 cases showed increased numbers of eccrine elements and numerous vascular channels in mid to low dermis. Other features included mucin (3 cases), infiltration of adipose tissue (9 cases), nerve hyperplasia (2 cases), thrombosis (3 cases), and hemosiderin (3 cases) as well. Conclusions Eccrine angiomatous hamartoma is an uncommon and benign malformation of skin. It is significant to know its clinical presentation and histopathology.
		2010 Vol. 43 (8): 587-588 [Abstract] ( 30 ) [HTML 0KB] [PDF 0KB] ( 0 )

	589
		Clinical efficacy of ALA-PDT in the treatment of condyloma acuminatum
		[Abstract] Objective To explore the efficacy，applicability and regret of ALA-PDT for the treatment of Condyloma Acuminatum. Methods 36 cases of condyloma acuminatum were treated with ALA-PDT. Results After the treatment, the cure rate is 91.7%,recurrence rate is 8.3%,the main cause of lesions left is because of the skin lesions size, and the frequency of the treatment. Conclusion The results confirm that ALA-PDT is a relative simple ,safe,effective treatment with a low recurrence rate for condyloma acuminatum. Especially for the small skin lesion in special area，the regrets of this method is patients have to be treated several times for the large skin lesions, and expensive to be treated .
		2010 Vol. 43 (8): 589-590 [Abstract] ( 6 ) [HTML 0KB] [PDF 0KB] ( 0 )

Expert Forum

	591
		A case of Waldenstrom’s macroglobulinemia with a skin mass as the first manifestation

		2010 Vol. 43 (8): 591-592 [Abstract] ( 3 ) [HTML 1KB] [PDF 0KB] ( 4 )

	593
		BW-2 type therapeutic instrument for herpes in the treatment of herpes zoster: a randomized controlled clinical trial

		2010 Vol. 43 (8): 593-594 [Abstract] ( 3 ) [HTML 1KB] [PDF 0KB] ( 1 )

	595
		Brivudine：an antiviral agent

		2010 Vol. 43 (8): 595-597 [Abstract] ( 4 ) [HTML 1KB] [PDF 0KB] ( 1 )

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