A 24-year-old man presented with a 6-year history of pustules,atrophic scars,and alopecia of the scalp.Dermatological examinations showed generalized alopecia and atrophic scarring of the scalp.A few hairs remained at the vertex region with keratotic papules,pustules,or black sears around the hair follicles.There were also residual hairs at the forehead,temples,and occipital region near the hairline.Clusters of hairs were noted in the occipital region,and keratotic papules were observed around the hair follicles.Erythema,scales,and follicular keratotic papules were found in the superciliary arch.The eyebrows and axillary hairs partially shed and were sparse.Follicular keratotic papules were also found on both cheeks,axillae,chest,abdomen,back and limbs.Stomatological examinations revealed a large space between the upper and lower anterior teeth,anteverted upper anterior teeth,congenital absence of (+1) tooth,deep overbite and deep overjet of anterior teeth.He had a fissured tongue which lacked filiform papillae.Pathological examinations of the skin lesionsshowedathickenedspinouslayer andmassiveinfiltrationsof plasmacytes, neutrophils, and multinucleated giant cells around hair follicles.A diagnosis of folliculitis spinulosa decalvans was made based on the clinical manifestations and histopathological findings.

Objective To evaluate therapeutic effects of wedge resection on male paraurethral duct dilatation following gonococcal paraurethral duct infection. Methods With the aid of high-frequency ultrasound images, 11 male patients with paraurethral duct dilatation following gonococcal paraurethral duct infection were treated with wedge resection. The data were collected, including the surgical duration, amount of bleeding during the surgery, period of wound healing and complications. If the ostium beside the external urethral orifice disappeared within 4 weeks after the surgery, there was no discharge from the ostium with pressure, and no tubular echoic area was observed by high-frequency ultrasound imaging, the patient was considered to be recovered. If none of the above three conditions could be met, the surgical treatment was considered to be ineffective. Results The average surgical duration was 19.19 ± 2.71 minutes(range, 14-23 minutes), the average amount of bleeding during the surgery was 11.09 ± 2.07 ml (range, 8-14 ml), and the average period of wound healing was 14.91 ± 1.45 days(range, 13-17 days). Of the 11 patients, 10 were cured, and 1 showed no response. No complications were observed in any of the 11 patients, and no defects formed in the glans penis. Conclusion Wedge resection is a kind of effective therapy for paraurethral duct dilatation following gonococcal paraurethral duct infection in males.

Objective To investigate the morphologic characteristics of gonococcal inflammation of paraurethral glands in males. Methods Eleven male patients with gonococcal inflammation of paraurethral glands were examined by both real-time ultrasound imaging (Siemens Acuson X300) and 3.0 T magnetic resonance imaging (MRI, Philips Achieva). Results High-frequency ultrasound imaging revealed tubular echoic areas with well-defined borders and smooth margins in all the patients. The inside of these tubular areas was weak-echoic. These tubular echoic areas were blind in one end, but open in the other end, and ran in parallel with the urethra. The mean lumen diameter was 1.1 ± 0.2 mm (range, 0.7 - 1.3 mm) , and the mean lumen length was 8.4 ± 0.6 mm (range, 7.0 - 12.0 mm). Anechoic liquid-filled areas were seen in the tubular echoic areas in two patients. Paraurethral ducts were not detected by 3.0 T MRI in these patients. Conclusions High-frequency ultrasound imaging can clearly show the morphologic characteristics of gonococcal inflammation of paraurethral glands in males, and provide valuable ultrasound images for surgery.

Objective To investigate the healing degree of lesions of herpes zoster in the head and face and the risk factor of the discosmetic sequelae.Methods 92 case of herpes zoster in the head and face were enrolled in this study.The patients were treated in dermatological clinic of Changshu No.1 People's Hospital from Jan.2017 to Jun.2018.The clinical data were recorded,such as the time of control,improving and healing of lesion,sex,age,position,the time of therapy starting and the behavior of scratching,extrusion and divest crust.The blood glucose and serum albumin of patients were measured.We observed the remained scars and performed statistic analysis.Results In diabetes group,the control and healing time was (2.40±1.28) d and (10.38+2.47) d respectively,meanwhile the control and healing time was (1.72 ± 0.94) d and (8.32 ± 2.66) d respectively in non-diabetes group (P＜0.05).The single factor analysis indicated that the age,position,diabetes,lesion extrusion,divest crust were the correlation factors of the zoster scar in head and face (P＜0.05).Nevertheless the multifactor logistic regression indicated that the position,diabetes and divest crust were independent risk factors of the zoster scar in head and face (P＜0.05).Conclusions The healing of herpes zoster is affected by diabetes.The independent risk factors of zoster scar in head and face are non-trigeminal nerves positions,diabetes and divest crust.

Objective: To observe the changes of skin lesion, neuralgia and blood pressure in hypertension patients and non-hyperension patients before and after the early formal treatment on herpes zoster in the head and face. Methods: Clinical data were collected from June 2015 to May 2018 in the Department of Dermatology, the First People＇s Hospital, Changshu, Jiangsu province. In 104 cases of hospitalized patients with herpes zoster, 46 cases had high blood pressure (hypertension group); 58 cases did not have high blood pressure (non-hypertension group). The skin lesion, numerical rating scale (NRS) and blood pressure changes were compared between the two groups before and after treatment. Results: A total of 99 patients completed treatment; 45 cases in the hypertensive group included 25 males, 20 females, aged 35 to 71 (52.40±12.51) years; 54 cases in the non-hypertensive group included 30 males and 24 females, aged 36 to 75 (52.62±12.67) years. There was no statistically significant difference in the time of control, improving and healing of skin lesion (t=-0.457, -0.607 and 1.399, P>0.05) . There was no statistically significant difference in NRS between the two groups before treatment (t=-0.009, P=0.993 >0.05). After treatment, the NRS of both groups decreased compared with those before treatment, and the difference was statistically significant (F=151.130, 181.444, P<0.05). There was no significant difference in NRS between the two groups after treatment (Z=-0.032, -0.154, -0.149 and -0.426, P>0.05). In the hypertension group, the rate of blood pressure increase before treatment was 62.22%, and the blood pressure decreased after treatment compared with that before treatment. The difference was statistically significant (P<0.05). In the non-hypertension group, the rate of increase of blood pressure before treatment was 5.56%, and the blood pressure after treatment was lower than before treatment. The difference was not statistically significant before and after treatment (P>0.05). Conclusions Blood pressure can be increased when herpes zoster occurs. After early formal treatment of herpes zoster, skin lesion healed, neuralgia reduced and blood pressure can return to normal. The history of hypertension and the increase of blood pressurd before treatment has no effect on the recovery of skin lesion and neuralgia.

Objective:To observe the changes of skin lesion, anxiety and depression in patients with facial hormone-dependent dermatitis before and after treatment.Methods:Ninty-two cases of hormone-dependent dermatitis were collected from October 2014 to December 2020 in the Department of Dermatology, the First People＇s Hospital of Changshu, Jiangsu province, including 24 males and 68 females, aged 18 to 52 (31±10) years. The skin lesions and subjective symptoms changes were compared 2 weeks and 4 weeks after treatment. Depression and anxiety changes were compared before and after treatment with Hamilton depression scale and Hamilton anxiety scale. Telephone follow-up was conducted 4 weeks and 8 weeks after treatment.Results:The skin lesions and subjective symptoms of the 92 cases were improved in different degrees after 2 weeks and 4 weeks treatment, and the effective rates were 52.17% (48 cases) and 88.04% (81 cases) respectively, and the difference was statistically significant ( Z=-9.24, P<0.01). The depression scores (16.89±4.53) before treatment were significantly higher than those after treatment (4.38±2.10), and the difference was statistically significant ( t=35.79, P<0.01). 28 cases (30.43%) had clinically significant depression symptoms before treatment, and none after treatment. The difference was statistically significant ( Z=-5.39, P<0.01). The scores of anxiety (14.39±3.97) before treatment were significantly higher than those after treatment (4.46±1.67). and the difference was statistically significant ( t= 28.87, P<0.01). 50 cases (54.35%) had clinically significant anxiety symptoms before treatment, and none after treatment. The difference was statistically significant ( Z=-7.07, P=<0.01). The total scores of Hamilton depression scale were positively correlated with course of disease before and after treatment ( r=0.27, P<0.05; r=0.22, P<0.05). The total scores of Hamilton anxiety scale were positively correlated with course of disease before and after treatment ( r=0.29, P<0.01; r=0.35, P<0.01). They were followed up by telephone 4 weeks and 8 weeks after the end of treatment, and there was no relapse. Conclusions:Facial hormone-dependent dermatitis can affect appearance, leading to depression and anxiety, and early and full treatment can achieve satisfactory results.

Objective To verify the change of the anxiety and depression of patients anteriorposterior treatment at paraurethral duct dilitation after gonococcal infection of paraurethral duct.Methods Twenty-eight patients of paraurethral duct dilatation after male gonococcal infection of paraurethral duct were enrolled,and the patients were treated in the Department of Dermatology and Venerology,the First People's Hospital of Changshu City.The anxiety and depression of patients anteriorposterior treatment were assessed and compared with Hamilton depression scale and Hamilton anxiety scale.Results The total scores of Hamilton depression scale and Hamilton anxiety scale before treatment were positively correlated with course of disease (r =0.481,P =0.0095;r =0.549,P =0.0025).The total scores of Hamilton depression and anxiety before treatment were from 1 to 31 (18.9±7.5) and from 4 to 30 (14.9±6.8).The symptoms of depression and anxiety appeared in 11 patients and 15 patients respectively.The total scores of Hamilton depression andanxiety after treatment were from 0 to 8 (4.3±1.7) and from 0 to 8 (3.3±1.7).There was no symptom of depression and anxiety.The difference of the total score of Hamilton depression and anxiety before and after treatment had statistical significance (t =12.270,P＜0.001,t =10.626,P＜0.001).The difference of positive rate of depressive and anxious symptom before and after treatment had statistical significance too (x2 =9.05,P=0.003;x2 =13.06,P=0.000).Conclusions The sequelae of gonococcal paraurethral duct infection in male paraurethral duct dilatation can result in the anxiety and depression of patients,which should be treated.Effective therapy can relieve or cure the anxiety and depression of patients without the assistance of psychotropic drugs.

Objective:To investigate ultrasonographic manifestations of gonococcal infections of the penile skin and accessory glands in men, and to assess their clinical significance.Methods:From January 2014 to January 2021, male patients with gonococcal infections of the penile skin and accessory glands were collected from Department of Dermatology, Changshu No.1 People′s Hospital. The diagnosis had been confirmed by laboratory examinations, and these patients had not received relevant treatment. The real-time ultrasound imaging system SIEMENS ACUSON X300 was used to examine the penile skin and accessory gland lesions infected with Neisseria gonorrhoeae, with the probe frequency ranging from 7.5 to 15 MHz. Patients with tubular anechoic fluid-filled areas on the high-frequency ultrasound images received a single dose of intramuscular ceftriaxone (1 g) ; those with oval-shaped anechoic fluid-filled areas on the high-frequency ultrasound images received incision and drainage followed by intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days; those with hypoechoic or mixed echoic areas on the high-frequency ultrasound images received intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days, and if the nodules did not regress after 1-month treatment, local resection would be performed. One month after the treatment, the patients were followed up, and the efficacy was evaluated. Results:A total of 32 male patients with gonococcal infections of the penile skin and accessory glands were collected. They were aged 28.54 ± 3.27 years, all had a history of non-marital sexual contact, and the duration from non-marital sexual contact to the onset of symptoms was 4.45 ± 1.03 days. The disease course was 8.64 ± 1.87 days. Lesions were all solitary, and located at the external urethral meatus in 16 cases (50.00%) , at the glans penis in 7 cases (21.88%) , beside the foreskin frenulum in 5 cases (15.62%) , and at the penile raphe in 4 cases (12.50%) . Sixteen patients (50.00%) presented with sinus-like lesions, 9 (28.13%) with abscesses, 7 (21.87%) with nodules, and all had tenderness on palpation. High-frequency ultrasound examination showed tubular anechoic fluid-filled areas in 16 cases (50.00%) , oval-shaped anechoic fluid-filled areas in 7 cases (21.88%) , hypoechoic areas in 5 cases (15.62%) , and mixed echoic areas in 4 cases (12.50%) . Gonococcal infections involved the cavernous body of the urethra in 16 cases (50.00%) , cavernous body of the penis in 5 cases (15.62%) , and subcutaneous tissue of the penis in 11 cases (34.38%) . After the treatment, all the patients were cured.Conclusion:High-frequency ultrasound can be used in the assessment of skin lesions and selection of treatment regimens for male patients with gonococcal infections of the penile skin and accessory glands.

BACKGROUND: We aim to explore the association between self-reported snoring and hypertension among adults aged 30-79 in Chongqing, China. METHODS: A total of 23,342 individuals aged 30-79 were included at baseline from August 2018 to January 2019, and the final sample size for the analysis was 22,423. Face-to-face interviews and physical examinations were conducted by trained investigators. Logistic regression was performed to study age-specific and gender-specific associations between snoring and hypertension. RESULTS: Frequent snoring was associated with the risk of hypertension for each age and gender group, and the frequency of snoring was positively correlated with the risk for hypertension. For the three age groups (< 45, 45-59, ≥ 60), compared with the non-snoring group, those who snore often had a 64.5%, 53.3%, and 24.5% increased risk of hypertension (< 45: OR = 1.65, 95%CI 1.34-2.02; 45-59: OR = 1.53, 95%CI 1.37-1.72; ≥ 60: OR = 1.25, 95%CI 1.09-1.42), respectively. For men and women, those who snore often had a 46.8% and 97.2% increased risk of hypertension, respectively, than the non-snoring group (men: OR = 1.47, 95%CI 1.33-1.63; women: OR = 1.97, 95%CI 1.75-2.23). CONCLUSIONS People who snore frequently should pay close attention to their blood pressure levels in order to achieve early prevention of hypertension, particularly for snorers who are female and aged under 45; importance should be attached to their blood pressure control.
Adult ; Aged ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Hypertension/etiology* ; Male ; Middle Aged ; Self Report ; Snoring/complications*