摘要
4岁男性患儿,面部、四肢散在红斑、水疱、结痂及瘢痕6个月。皮肤科情况:面部、四肢散在黄豆至甲盖大小红斑、水疱及萎缩性瘢痕,部分红斑、水疱中央出现糜烂、坏死、结痂。皮损组织病理示:局部表皮坏死缺失,基底细胞局部空泡样变性,真皮浅中层血管、附属器周围灶状淋巴细胞浸润,细胞无明显异形性,坏死的表皮下方结缔组织呈均质性嗜酸性坏死。免疫组化染色显示:真皮浅中层血管、附属器周围淋巴细胞CD45RO、CD3表达均阳性,CD4、CD20、CD79α阴性。分子检测:EBV编码RNA(EBER)和T淋巴细胞基因重排均阴性。诊断:种痘样水疱病。治疗:嘱避光,予羟氯喹及复方甘草酸苷口服,红斑、水疱处外用莫匹罗星软膏,每日1次。1个月后,红斑、水疱破溃、坏死的创面愈合,部分留有瘢痕,随访6个月偶有复发,避光后可自行痊愈,愈后留有瘢痕。
A 4-year-old boy presented with scattered erythema, blisters, scabs and scars on his face and limbs for half a year. Dermatology examination revealed soybean to nail sized erythema, blisters, and scars were scattered on the face and limbs, as well as erosion, necrosis and scabs were found in the center of some erythema and blisters. Histopathological examination showed that local epidermal necrosis, vacuolar degeneration of basal cells, focal infiltration of lymphocytes around the blood vessels and appendages in the upper dermis, and the connective tissue under the necrotic epidermis showed homogeneous and eosinophilic necrosis. Immunohistochemical staining showed that the expression of CD45 RO and CD3 was positive, and CD4, CD20 and CD79α was negative for the lymphocytes around the blood vessels and appendages. Diagnosis: Hydroa vacciniforme.
作者
邓维
苏伟
张高磊
张海花
刘晓雁
DENG Wei;SU Wei;ZHANG Gao-lei(Department of Dermatology,Capital Institute of Paediatrics,Beijing 100020,China)
出处
《实用皮肤病学杂志》
2020年第5期311-313,共3页
Journal of Practical Dermatology
