摘要
26岁女性患者,颈部、躯干红斑伴发热20余d.颈部、肩部及胸前V字区可见对称性分布的片状暗红斑,呈苔藓样改变,背部可见对称性分布的鞭笞样红斑.皮损组织病理示:角质层Munro微脓肿,表皮海绵水肿,表皮中上层散在单个或多个坏死角质形成细胞,真皮浅中层血管周围少量淋巴细胞和嗜酸粒细胞浸润.诊断:成人Still病.甲泼尼龙琥珀酸钠40 mg静脉滴注治疗10 d,患者发热、皮损及关节酸痛逐渐消退,糖皮质激素调整为醋酸泼尼松30 mg/d口服出院.门诊随访6周,醋酸泼尼松逐渐减量至停药,病情无复发.
A 26-year-old female patient experienced erythema on the neck and trunk with fever for more than 20 days.Physical examination showed that dark erythematous patche s with lichenoid changes symmetrically distributed on the neck,shoulders and V-shaped area of chest,as well as flagellate erythema on the back,and the area of skin lesions was about 7% of the body surface area.The histopathology of the lesion showed that Munro microabscess in the stratum corneum,spongiosis,single or multiple necrotic keratinocytes scattered in the upper and middle epidermis,and a few lymphocytes and eosinophils infiltrated around blood vessels in the superficial and middle dermis.Diagnosis:adult-onset Still’s disease,after 10 days of intravenous drip treatment with methylprednisolone sodium succinate 40 mg daily,the symptoms of fever,joint pain and skin lesions gradually subsided,then the glucocorticoid treatment was adjusted to prednisone acetate tablets 30 mg per day,and the patient was discharged from hospital.During the 6-week follow-up,prednisone acetate was gradually reduced to discontinuation,and there was no recurrence.
作者
叶文正
方木平
YE Wen-zheng;FANG Mu-ping(Department of Dermatology',Xiaogan Central Hospital Affiliated to Wuhan University of Science and Technology,Xiaogan 432000,China)
出处
《实用皮肤病学杂志》
2021年第1期52-53,共2页
Journal of Practical Dermatology
关键词
Still病
成人
红斑
鞭笞样
皮损
苔藓样
Still’s disease,adult-onset
Erythema,flagellate
Lesion,lichenoid
