溃疡型皮肤结节病
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摘要
报告1例溃疡型皮肤结节病。患者女,53岁。右额部一红色小结节3年余,增大并破溃3个月就诊。皮肤科检查:右侧额部一红色浸润斑块,表面溃烂及结痂,右唇上方圆形红色浸润斑块,境界清楚,表面粗糙伴少量鳞屑。皮损组织病理检查:真皮内上皮样细胞肉芽肿,部分裸结节,部分包含朗汉斯巨细胞,中央可见纤维蛋白样变性。结核感染特异性T细胞检测(T.SPOT-TB)及抗酸染色均阴性。予规范抗结核及抗非结核分枝杆菌治疗无效,结合患者临床皮损、实验室检查和皮损组织病理检查结果,诊断为溃疡型皮肤结节病。
A case of ulcerative sarcoidosis is reported. A 53-year-old female presented with a 3-year history of a nodular lesion on the forehead, which gradually enlarged with ulceration and exudation for 3 months. Dermatological examination showed one demarcated erythematous, infiltrated plaque with ulceration, crusts and scales on the right side of the forehead and one on the right side above the lip. Histopathological examination revealed epithelial granuloma, nodules, infiltration of Langhans giant cells and central fibrinoid degeneration. T.SPOT-TB and acid fast staining were negative, and the patient did not respond well to the treatments of anti-tuberculosis or anti-atypical mycobacteria. The diagnosis of ulcerative sarcoidosis was confirmed based on her clinical, laboratory and histopathological findings.
A case of ulcerative sarcoidosis is reported. A 53-year-old female presented with a 3-year history of a nodular lesion on the forehead, which gradually enlarged with ulceration and exudation for 3 months. Dermatological examination showed one demarcated erythematous, infiltrated plaque with ulceration, crusts and scales on the right side of the forehead and one on the right side above the lip. Histopathological examination revealed epithelial granuloma, nodules, infiltration of Langhans giant cells and central fibrinoid degeneration. T.SPOT-TB and acid fast staining were negative, and the patient did not respond well to the treatments of anti-tuberculosis or anti-atypical mycobacteria. The diagnosis of ulcerative sarcoidosis was confirmed based on her clinical, laboratory and histopathological findings.
引文
[1]Ali MM,Atwan AA,Gonzalez ML.Cutaneous sarcoidosis:updates in the pathogenesis[J].J Eur Acad Dermatol Venereol,2010,24(7):747-755.
[2]Marchell RM,Judson MA.Chronic cutaneous lesions of sarcoidosis[J].Clin Dermatol,2007,25(3):295-302.
[3]Mizuno K,Nguyen CT,Ueda-Hayakawa I,et al.Annular lesions of cutaneous sarcoidosis with granulomatous vasculitis[J].J Cutan Pathol,2017,44(5):494-496.
[4]Ichiki Y,Kitajima Y.Ulcerative sarcoidosis:case report and review of the Japanese literature[J].Acta Derm Venereol,2008,88(5):526-528.
[5]Tong C,Zhang X,Dong J,et al.Comparison of cutaneous sarcoidosis with systemic sarcoidosis:a retrospective analysis[J].Int J Clin Exp Pathol,2014,7(1):372-377.
[6]Nguyen YT,Dupuy A,Cordoliani F,et al.Treatment of cutaneous sarcoidosis with thalidomide[J].J Am Acad Dermatol,2004,50(2):235-241.
[2]Marchell RM,Judson MA.Chronic cutaneous lesions of sarcoidosis[J].Clin Dermatol,2007,25(3):295-302.
[3]Mizuno K,Nguyen CT,Ueda-Hayakawa I,et al.Annular lesions of cutaneous sarcoidosis with granulomatous vasculitis[J].J Cutan Pathol,2017,44(5):494-496.
[4]Ichiki Y,Kitajima Y.Ulcerative sarcoidosis:case report and review of the Japanese literature[J].Acta Derm Venereol,2008,88(5):526-528.
[5]Tong C,Zhang X,Dong J,et al.Comparison of cutaneous sarcoidosis with systemic sarcoidosis:a retrospective analysis[J].Int J Clin Exp Pathol,2014,7(1):372-377.
[6]Nguyen YT,Dupuy A,Cordoliani F,et al.Treatment of cutaneous sarcoidosis with thalidomide[J].J Am Acad Dermatol,2004,50(2):235-241.