Dermoscopy and reflectance confocal microscopy finding of different anatomic sites of Langerhans cell histiocytosis.

BACKGROUND: Recognizing Langerhans cell histiocytosis (LCH) might be a challenge due to its rarity. Reflectance confocal microscopy (RCM) and dermoscopy were emergent promising non-invasive technique as auxiliary tools in diagnosis of different skin conditions. However, the RCM and dermoscopic features of LCH had been less investigated. To reveal the common RCM and dermoscopic features of LCH. MATERIALS AND METHODS: Forty cases of LCH were retrospectively analyzed according to age, locations, clinical, RCM, and dermoscopic features from September 2016 to December 2022. To reveal the differences and common in clinical, RCM, and dermoscopic features that occur in different anatomic location. RESULTS: In the study, sites of predilection include the trunk 31/40 (77.5%), extremity 21/40 (52.5%), face 14/40 (35%), scalp 11/40 (27.5%), vulvar 4/40 (10%), and nail 2/40 (5%). All LCHs had the common RCM features. There were significant differences in clinical and dermoscopic features for age and lesion anatomic site. The common dermoscopic features for scalp, face, trunk, and extremity were the erythematous scaly rash, purplish-red globules or patches, scar-like streaks with ectatic vessels. While the features for nail LCH were purpuric striae, onycholysis and purulent scaly rash, and the erosive erythematous plaque and purulent scaly rash for vulvar LCH. The common RCM features of all LCH showed a focal highly reflective dense image in the surface keratin layer, epidermis architectural disarray, obscuration of dermo-epidermal junction, numerous polygonal, large, medium reflective, short dendrites cells in the epidermis, and dermis. All LCH involving the vulvar and nail did not manifest skin lesions. CONCLUSION: RCM and dermoscopy showed promising value for diagnosis and differentiation of LCH.

[Preliminary analyses on bacterial diversity and resistance in infection-related skin disorders].

OBJECTIVE: To explore the bacterial diversity and resistance in infection-related skin disorders. METHODS: The samples of blood, pyogenic fluid, exudate and skin dander were collected from 54 outpatients of chronic and recurrent skin disease and cultured for positive pathogens in the dermatological department of Peking University Third hospital from March 2010 to May 2011. Also their drug susceptibilities were examined. RESULTS: Among 63 bacterial strains of 22 species in 12 genus, the pathogens were Staphylococcus epidermidis, Staphylococcus aureus, Micrococcus luteus, group A Streptococcus pyogenes, Staphylococcus agalactiae, Corynebacterium sp., Bacillus subtilis, Bacillus cereus, Acinetobacter baumanii, A. lwoffii, Pseudomonas aeruginosa, Enterobacter cloacae, Rhizobium radiobacter, Sphingomonas paucimobilis, Enterococcus faecalis, Neisseria sicca and Neisseria gonorrhoeae. The percentage of methicillin-resistant coagulase negative staphylococci (MRCNS) was 46.4% (13/28) while the resistant rates of Styphylococci to ampicillin, penicillin, azithromycin, cefoxitin, clindamycin and SMZ-TMP were 88.6% (31/35), 88.6% (31/35), 68.6% (24/35), 37.1 (13/35), 28.6(10/35) and 26.5 (9/34) respectively. Gram negative bacilli were sensitive to ampicillin, amikacin sulfate, ceftazidime. CONCLUSION: There are a wide range of pathogenic bacterial species among refractory infection of outpatients. And drug resistance is among the reasons for refractory infections.