Publications (35)

  • Y Zhao · C.Y. Li · C.M. Wen · [...] · P Tu
    [Show abstract] [Hide abstract] ABSTRACT: Background: Actinic keratosis (AK) is one of the most common conditions treated by dermatologists in the western countries. Studies have shown that the AK prevalence in European, American, and Australian countries is 4.5-60%. No data of AK prevalence in China has been reported. Objective: This study aimed to explore the prevalence of AK in patients visiting dermatologists in two hospitals of China. Methods: This study was conducted in the dermatology departments of two teaching hospitals. All records for five years between 2008 and 2012 with clinically or pathologically diagnosed AKs were collected from the pathological databases of both hospitals. Data from these records were used to calculate the prevalence of AKs among the patients who were seen by dermatologists in these hospitals. To estimate the reliability of data from the previous database, a cross-sectional study was conducted simultaneously in the two hospitals from Oct. 15 to Dec. 08 in 2012 after all dermatologists in the two departments were re-trained with intense courses for recognizing AK clinically. Results: The prevalence of total clinical AK through 2008-2012 was 0.52‰ in 1,590,817 patient-visits in the two hospitals. The yearly prevalence of clinical AKs were 0.30-1.20‰. In the cross-sectional study, 72,437 clinical patients were screened and 76 patients (1.05‰) were identified to have clinically recognized AK. Conclusions: The overall prevalence of AKs in the patients visiting dermatologists in the two hospitals of China was 0.52‰, which is much lower than the prevalence in the western countries. This article is protected by copyright. All rights reserved.
    Article · Dec 2015 · British Journal of Dermatology
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    Y Zhao · C.M. Wen · N.N. Zhou · [...] · P Tu
    Full-text Article · Jun 2014 · Journal of the European Academy of Dermatology and Venereology
  • Y. Wang · X.-X. Chen · L.-S. Wu · P. Tu
    [Show abstract] [Hide abstract] ABSTRACT: Objective: To analyze the clinical and histopathological characteristics of cutaneous metastases of a cancer. Method: Retrospectively analyzed the clinical and pathological features, the primary sites of cancers and prognosis in 27 cases of cutaneous cancer metastases diagnosed in the department from 2006 to 2012. Results: There were 12 males and 15 females with the male to female ratio of 1:1.25. The average ages at the onset of skin lesions were aged 60 years (24-91). Nine cases (33.33%) were with single lesion and 18 cases (66.67%) with multiple lesions. The metastatic sites included the chest, abdomen, genital area, scalp, back, shoulder, and the extremities. Histopathological examination revealed that 20 cases (74.07%) were metastatic adenocarcinoma; 3 cases (11.11%) were metastatic squamous cell carcinoma; 3 cases (11.11%) were metastatic mucinous carcinoma, and 1 case (11.11%) was metastatic melanoma. Four of 16 followed up patients died, and the others continued to radiation and chemotherapy. Conclusions: With increasing incidence of cancers, cutaneous metastases increased in recent years. To raise awareness of cutaneous metastases is helpful for early diagnosis, treatment, and prolonging patients' life.
    Article · Dec 2013
  • Y.S. Huang · X.X. Chen · S.X. Yang · [...] · H Li
    [Show abstract] [Hide abstract] ABSTRACT: Background The epidemiological and clinical characterization data of skin malignancies and premalignancies in Chinese population is scarce and inadequate. Objective To systematically investigate the clinical features and the trend of skin malignancies and premalignancies in 1420 Chinese cases. Methods A total of 1398 patients (presenting 1420 skin tumours) were included. Clinical and demographic information for every individual was collected, including age, age of onset, sex, lesion location, disease duration and tumour histology, which was analyzed for each type of skin tumours. Results The number of skin malignancies and premalignancies increased over time, with Basal cell carcinoma (BCC) as the most common type (30.5%). The majority of the patients were above 60 years of age both at onset and at diagnosis (52.8% and 62.9%, respectively), yet around one-third of patients were between 35–59 years (35.3% and 31.2%, respectively). Skin malignancies and premalignancies were mainly located in the head and neck (58.6%), followed by the trunk (18.3%) and the extremities (15.0%). Of all BCCs, nodular BCC was the most common histologic subtype (62.8%), while 15.8% were classified as aggressive subtypes. Malignant melanoma (MM) comprised the lowest proportion of 3.7%, with 75% located on extremities. The diagnostic accordance rates varied from 49.5% to 90.4%, with BCC being 67.9%. Conclusions The clinical features of skin malignancies and premalignancies in this study showed some similarities with those observed in Caucasian and other Asian populations, with several distinguished features in Chinese patients also being recognized. Closer attention to suspicious lesions in young and middle-aged people is needed.
    Article · Aug 2012 · Journal of the European Academy of Dermatology and Venereology
  • W.-W. Li · H.-Z. Yang · L.-S. Wu · P. Tu
    [Show abstract] [Hide abstract] ABSTRACT: A case of mycosis fungoides presenting as persistent pigmented purpuric dermatosis is reported. A 48-year-old male presented with eruption on his lower extremities for 3 years, the lesions gradually aggravated and with occasionally itching. Dermatological examination disclosed erythematous and red-brown petechial patches on his waist, buttocks and lower extremities, and some dark brown pigmented patches on the dorsa of feet and hands with mild lichenification. Histopathological examination showed there was focal lymphocytic infiltration in the papillary and reticular dermis, and some lymphocytes showed atypical and significant epidermotropism. Immunohistochemical investigation showed tumor cells stained positive for CD3, CD5, CD4, CD8, TCRβ, and TIA1, and negative for CD20. Thus mycosis fungoides was diagnosed.
    Article · May 2012
  • B. Zhang · W. Chen · Y. Yang · [...] · P. Tu
    [Show abstract] [Hide abstract] ABSTRACT: A case of Multi-centric reticulohistiocytosis is reported. A 56-year-old male patient with papules, nodules and dark red plagues with edema on his face, trunk and extremities for more than 1 year, stiffness and deformity of the fingers, limitation of shoulder and knee joint activity, debility of the limbs for about 10 months. Radiography of the knees revealed destruction of joints and part of the articular facet had cystic lower density zones. Histopathological examination showed many single nucleated cells and multi-nucleated giant cells with ground-glass cytoplasm in the dermis and among the muscle cells. The final diagnosis was multi-centric reticulohistiocytosis.
    Article · Mar 2012
  • Y.S. Huang · D F Bu · X.Y. Li · [...] · H Li
    [Show abstract] [Hide abstract] ABSTRACT: Background Alterations of the PTCH1 gene have been found to contribute to both familial and sporadic basal cell carcinoma (BCC), especially in Caucasian patients. Furthermore, the majority of PTCH1 gene mutations in sporadic BCCs in Caucasian patients carry ultraviolet (UV) signatures, suggesting the key role of UV light in BCC development. However, sporadic BCC in non-Caucasian population has a lower incidence, and the pathogenesis remains largely unknown. To date, there has been no mutation analysis on PTCH1 gene in Chinese patients with sporadic BCCs. Objective To investigate genetic alterations of the PTCH1 gene in Chinese sporadic BCCs. Methods Direct sequencing was used to screen for mutations in PTCH1 in 31 microdissected samples in Chinese sporadic BCCs. In addition, single nucleotide polymorphisms (SNPs) were studied for loss of heterozygosity (LOH). Results Nineteen PTCH1 mutations in 17 of the 31 BCCs (54.8%) were identified. SNP analysis revealed LOH of PTCH1 in 10 of 23 BCCs (43.5%). Interestingly, the majority of mutations identified (63.2%) were insertion/deletion, which was different from the results in Caucasian cases whose mutations are predominantly point mutations. Only two (10.5%) of the remaining seven mutations were UV-specific C → T transition or tandem CC → TT transitions. All mutations occurred evenly throughout the entire PTCH1 protein domain without a hot-spot detected. Conclusion Mutations and LOH in PTCH1 were also highly prevalent in Chinese sporadic BCCs. However, UV light plays a less role in causing these mutations, suggesting other potential mechanisms in the development of sporadic BCC in Chinese patients.
    Article · Feb 2012 · Journal of the European Academy of Dermatology and Venereology
  • C. Chen · X.-X. Chen · P. Tu · [...] · Y. Wu
    [Show abstract] [Hide abstract] ABSTRACT: Systemic amyloidosis (SA) is a systemic metabolic disorder with extensive deposition of amyloid protein in skin, internal organs and mucous. Skin involvement occurs in 40% of SA patients and many of them consult dermatologists first. Here a case is presented with purpura, ecchymosis and plaque which had been misdiagnosed for many times and the diagnosis of primary systemic amyloidosis accompanied by multiple myeloma was confirmed in the end.
    Article · Dec 2010
  • S. Zhang · S. Adila · L. Nong · [...] · T. Li
    [Show abstract] [Hide abstract] ABSTRACT: Objective: To analyze the clinical and histopathological features, immunophenotypes and genetic phenotypes of the cases of primary cutaneous extranodal NK/T cell lymphoma-nasal type (EN-NK/T-NT). Methods: The clinical features and histological changes of two cases, a 60-year-old woman and a 75-year- old man, of primary EN-NK/T-NT were analyzed. The immunochemistry assay, in situ hybridization of EBV, and PCR for TCRγ rearrangement was also performed. Results: At the onset of the disease, both patients presented with skin lesions, multiple infiltrated erythema and ulcers on the legs, with no lesions on the midface. The histopathology of the skin lesion showed diffuse infiltration of moderate to large tumor cells in the dermis and subcutaneous tissue, with irregular dysplastic nuclei. The vessel wall was infiltrated with obvious apoptosis and necrosis. The tumor cells were positively stained for CD3ε, CD56, cytotoxic markers, T-bet and ETS-1 in both cases, and positively stained for CLA in one case. In situ hybridization showed that EBV existed in all tumor cells. TCRγ gene rearrangements were presented in germline configuration. Conclusions: The two cases reported show the same histopathologic features, immunophenotype and genetic phenotype as usual cases of EN-NK/T-NT, the carcinogenic mechanisms of which needs further study.
    Article · Nov 2010
  • B. Wang · X.-X. Chen · H.-Z. Yang · [...] · P. Tu
    [Show abstract] [Hide abstract] ABSTRACT: A case of a 24-year-old female presented with blisters which were distributed in annular form. Histopathologic examination showed a subepidermal blister with prominent neutrophil infiltrate with lymphocytes in the papillary dermis, perivascular and periadnexal locations. Direct immunofluorescence showed continuous linear deposits of IgA and IgG at the basement membrane zone. A diagnosis of linear IgA bullous dermatosis was made. Laboratory studies showed leucocytopenia, anemia, low albumin levels and rise of transaminases. Further examinations are consistent with the diagnosis of systemic lupus erythematosus.
    Article · Oct 2010
  • B. Zhang · H.-Z. Yang · X.-X. Chen · [...] · P. Tu
    [Show abstract] [Hide abstract] ABSTRACT: A case of younger Schimmelpenning syndrome is reported. A 95-day-old female child presented with a dark brown verrucous hyperplasia in a linear on her scalp, face and neck at birth and with epileptic fits for 15 days. There was an alopecia area on the anterior fontanelle. Eye examination showed a cystoid neoplasm of sclera extending to cornea on the inner canthus of her left eye. Nuclear magnetic resonance imaging of her head revealed arachnoid cysts in her temporal lobe. The diagnosis was made as Schimmelpenning syndrome.
    Article · Jul 2010
  • F. Zhang · P. Tu · D.-F. Bu · L.-S. Wu
    [Show abstract] [Hide abstract] ABSTRACT: Objective: To investigate the feasibility of laser capture microdissection (LCM) and genescan in T cell receptor gamma gene rearrangement in early mycosis fungoides. Methods: LCM to obtain lymphocytic infiltrates from tissue sections of skin biopsy specimens was used. T cell receptor gamma-chain polymerase chain reaction genescan analysis (TCR-γ-PCR-GSA) was used to analyze the clonality status of 9 patients with early MF and 2 patients with tumor-stage MF. Results: A monoclonal T cell infiltrate was demonstrated in 66.7% of early stage MF cases and in 100% of tumor stage MF patients. Conclusion: Applying LCM to clonality analysis of early MF could be more rapid and sensitive than conventional methods, and to introduce this approach into the routine diagnosis is recommended.
    Article · May 2010
  • Y Wang · S Yang · L Wu · P Tu
    [Show abstract] [Hide abstract] ABSTRACT: Tacrolimus has shown promising results in the treatment of various dermatological diseases, including hair loss. The direct effect of tacrolimus on hair follicles and its underlying mechanisms have rarely been investigated. In this study, we investigated the effects of topical tacrolimus on anagen in the hair cycle and on the expression of vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1) mRNAs in mouse skin. Topical tacrolimus 0.1% ointment was applied to one side of the skin of depilated C57BL/6 mice. Skin samples from both sides were taken during the study. Vegf and Igf-1 mRNA were determined by quantitative RT-PCR. No obvious difference in skin colour, hair cycling or histological features was found between the treated and untreated skin, but the levels of Vegf mRNA and Igf-1 mRNA were markedly decreased in the treated skin in late anagen, compared with those in untreated skin.
    Article · Dec 2009 · Clinical and Experimental Dermatology
  • H.-T. Zhuang · H. Li · X.-X. Chen · [...] · P. Tu
    [Show abstract] [Hide abstract] ABSTRACT: A case of malignant change of eccrine poroma is reported. A 47-year-old male presented with a nodule on the left hypofhenar for 10 years. Dermatological examination showed a small round reddish nodule on the hypothenar of his left hand, about 0.5 cm in diameter. Histopathology showed eccrine poroma with active proliferation, and atypical cells were observed in part of the tumor. The diagnosis was malignant eccrine poroma at an early stage. The lesion was excised.
    Article · Sep 2009
  • Y. Wang · W.-W. Li · Y. Yang · [...] · P. Tu
    [Show abstract] [Hide abstract] ABSTRACT: A rare case of multiple myeloma complicated with pyoderma gangrenosum is reported. A 58-year-old Chinese woman presented multiple papules on the left lower leg, which developed to plaques and became ulceration during four months. A biopsy of the lesion demonstrated leucocytoclastic vasculitis. IgA lambda light-chain was highly detected, and bone marrow biopsy revealed with plasmacyte and juvenile plasmacyte hyperplasia, which indicated the diagnosis of multiple myeloma IgA λ type. IgA paraprotein may contribute to the pathogenesis of pyoderma gangrenosum.
    Article · Aug 2009
  • R. Ye · P. Tu · L.-S. Wu · [...] · W. Chen
    [Show abstract] [Hide abstract] ABSTRACT: Objective: To improve the diagnosis and treatment of cutaneous vasculitis through analyzing the clinical and pathological characteristics of 163 cases. Method: The clinical and pathological data of 163 patients with cutaneous vasculitis were retrospectively analyzed. Results: There were 64 male and 99 female patients, with an average age of 39.8 years and the disease-course of 3.68 years on average. The associated predisposing factors were infection (15.9%), systemic immunological diseases (15.9%), seasonal factor (8.59%), medicines (3.68%), food (1.84%) and tiredness (0.6%). The cause of more than half (52.7%) of the patients was unknown. Histopathology of skin specimens could be divided into 5 types: leukocytoclastic vasculitis (60 cases, accounting for 36.8%), lymphocytic vasculitis (17, 10.43%), granulomatous vasculitis (14, 8.59%), segmental hyalinizing vasculitis (3, 1.84%), and vasculitis complicated with panniculitis (69, 42.3%), fifty-seven patients of the latter (82.6%) were leukocytoclasitic vasculitis. The clinical manifestations were consistent with the pathological features in some but not with all the cases. Conclusion: Leukocytoclastic vasculitis is most common in these cases, accounting for 71.7%, some were accompanied by panniculitis and mimicked panniculitis clinically. The histopathological examination is needed in this situation for the final diagnosis and proper treatment.
    Article · Jul 2009
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    X Cao · Z Lin · H Yang · [...] · Y Yang
    [Show abstract] [Hide abstract] ABSTRACT: Autosomal recessive lamellar ichthyosis (LI) is a severe skin disorder characterized by generalized hyperkeratosis. Gene mutation in transglutaminase 1 (TGM1), which mediates cross-links in the formation of the cell envelope during terminal differentiation of epidermis, has been identified as a cause of LI. To determine mutations of TGM1 gene in three Chinese families with LI. The TGM1 gene was sequenced to identify disease-causing mutations in the three families with LI. One of the results was confirmed by using reverse transcriptase PCR and in situ hybridization. An in situ transglutaminase (TGase) 1 assay was performed to estimate TGase 1 activity in the patients' skin. Four novel mutations of keratinocyte TGase1 (Q203X, D254N, R687H and IVS4 + 1G-->T) were found in the three families. No TGase 1 mRNA was detected in patient skin using RT-PCR and in situ hybridization, and the in situ TGase assay showed that there was no or decreased TGase 1 activity in patient skin. Our findings suggest that four novel mutations in TGM1 gene result in decrease or absence of TGase activity in the skin and, as a consequence, cause the phenotype of LI.
    Full-text Article · May 2009 · Clinical and Experimental Dermatology
  • Y Wang · T Li · P Tu · [...] · X J Zhu
    Article · May 2009 · Clinical and Experimental Dermatology
  • W.W. Li · X.X. Chen · J Yu · [...] · P Tu
    Article · May 2009 · British Journal of Dermatology
  • F. Zhang · L.-S. Wu · Z. Wan · [...] · P. Tu
    [Show abstract] [Hide abstract] ABSTRACT: A case of hyperimmunoglobulinemia E syndrome with subcutaneous chronic mycosis is reported. A 24-year-old male patient presented with erythema, paplues and patches on his extremities and trunk for 23 years, subcutaneous nodule and inguinal swollen lymph nodes for 4 years. His peripheral blood eosinophils and serum IgE levels were high. Skin biopsy revealed that chronic dermatitis changes and cosinophils could be seen in the dermis. Silver staining of inguinal swollen lymph node in the revealed hyphae, pseudohyphae and spores.
    Article · Oct 2008