摘要
报告1例浅表肉芽肿性脓皮病。患者男,34岁。双小腿、双臀部出现环状暗红斑、坏死、结痂伴疼痛10个月余。皮肤科检查:双侧臀部外侧可见约5 cm×5 cm对称性环形暗红斑,中央粗糙不平,表面结痂,边缘紫红色堤状隆起,有黑色痂,外周有淡紫红晕。双侧小腿屈侧各可见一暗红色圆形斑块,右侧约20 cm×20 cm,左侧约15 cm×15 cm;中央呈灰白色,粗糙不平,边缘有隆起红褐色斑,轻度疣状增生,表面少许脓血性渗出物,周围有紫红晕,压痛明显。组织病理示表皮角化过度伴角化不全,棘层增生肥厚,表皮突延长并增宽,棘细胞间水肿,部分表皮坏死缺失,真皮浅层部分血管壁血管纤维蛋白样变性,血管周围淋巴细胞、组织细胞、中性粒细胞及嗜酸性粒细胞浸润,PAS染色阴性。组织块真菌培养阴性。诊断为:浅表肉芽肿性脓皮病。诊断明确后给予甲泼尼龙60 mg/d及环胞素300 mg/d治疗,半个月后皮损明显好转。
A case of superficial granulomatous pyoderma is reported. A 34-year-old male presented with dark red annular necrotic and crusted erythema with soreness on both legs and buttocks for more than ten months. Physical examination showed two symmetrically distributed orbicular erythemas on the lateral sides of buttocks, 5 cm × 5 cm in size, with a central rough surface, elevated crusted border and a peripheral brownish red halo. There were tender, grayish white annular plaques on the flexural surface of both legs, the size of the right one was 20cm×20cm and the left one 15cm×15cm. The plaques showed rough center, elevated reddish brown border with mild verrucous hyperplasia and sanguinopurulent exudation. Similarly, a peripberal halo was seen also. Histopathologieal examination ~vealed hyperkeratosis, parakeratosis, acamhosis, elongation of the rete ridges, spongiosis, and partial necrosis and loss of the epidermis. Fibrinoid degeneration of blood vessel walls in the superficial dermis was shown, with perivascular infiltration of lymphoeytes, histioeytes, neutrophils and eosinophils. PAS staining and fungal euhure revealed negative results. The final diagnosis was superficial granulomatous pyoderma. The skin lesions improved markedly after treating with methylprednisolone （60 mg/d） and eyclosporin A （300 rag/d） for half a month.
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2013年第1期26-28,共3页
Journal of Clinical Dermatology
关键词
浅表肉芽肿性脓皮病
superficial granulomatous pyoderma
gangrenous pyoderma
