摘要
目的探讨近端指间关节周围胶原沉积症(pachydermodactyly,PDD)的临床表现、诊断和鉴别诊断。方法对1例PPD患者的临床资料、关节累及情况、实验室检查、X线表现及病理学检查进行总结分析,并对2005～2011年国内相关内容文献进行复习。结果该患者双手近端指间关节肿胀,无疼痛;查体可见双手第2、3、4近端指间关节侧面呈对称性梭形膨大,关节无压痛,活动自如;实验室及免疫学检查均为阴性。X线片示软组织肿胀,无骨质和关节异常改变;皮肤组织病理学检查显示表皮增生伴角化过度,真皮层增厚伴胶原纤维增多和成纤维细胞轻度增生,无炎性细胞浸润,诊断为PDD。结论 PDD虽是一种少见的风湿科良性疾病,但根据其临床表现、放射学、血清学检查、组织病理学检查即可作出诊断。临床上应引起重视,避免误诊、误治。
Objective To investigate the clinical manifestations, diagnosis and differential diagnosis of pachydermodactyly （PDD）. Methods The clinical data, laboratory tests, X-ray findings and pathological examinations of a PPD patient was reviewed. Results The patient＇ s examination showed that the 2, 3 fusiformed but without tenderness. analyzed, and the relevant Chinese literature from 2005 to 2011 were proximal interphalangeal joint were swollen but without pain. Physical , 4 proximal interphalangeal joint symmetrically enlarged, which was These joints could move freely. The laboratory and immunological tests were all negative. X-ray showed soft tissue swelling, no bone and joint abnormalities were detected. Skin histopathological examination showed epidermal hyperplasia with hyperkeratosis, and the dermal layer was thickened with increased collagen fibers while fibroblasts presented with mild hyperplasia. No inflammatory cell infiltration were found. The final diagnosis of this patient was PDD. Conclusions PDD is a rare but benign disease, and generally do not need treatment. Therefore, attention should be paid to avoid misdiagnosis and inappropriate treatment.
出处
《中华临床免疫和变态反应杂志》
2013年第1期67-71,F0003,共6页
Chinese Journal of Allergy & Clinical Immunology
