结节性皮肤狼疮黏蛋白病3例
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摘要
患者中2例女性,1例男性,年龄17～41岁。3例患者均表现为结节或斑块。3例患者均有相似的组织病理改变,真皮浅、深层血管及附属器周围可见淋巴细胞为主的炎症细胞灶状浸润,真皮中上层胶原纤维束之间可见黏蛋白样物质沉积;阿辛蓝染色及狼疮带实验阳性。3例均诊断为结节性皮肤狼疮黏蛋白病,且例1符合系统性红斑狼疮诊断。3例患者均对糖皮质激素及抗疟药治疗反应较好。
The patients included two women and one man,aging from 17 to 41 years. All the patients presented with nodules or plaques.Histological examination revealed similar changes in all the patients,lymphocyte dominated inflammatory cells infiltrating in perivascular area of superficial and deep dermis and also periadnexal area,interstitial mucin deposition in the papillary and reticular dermis. Alzian blue staining and lupus band tests presented positive. Three cases were diagnosed as nodular cutaneous lupus mucinosis and the case 1 was also diagnosed as systemic lupus erythematosus. All the patients responded well to glucocorticosteroids and antimalarial agents.
The patients included two women and one man,aging from 17 to 41 years. All the patients presented with nodules or plaques.Histological examination revealed similar changes in all the patients,lymphocyte dominated inflammatory cells infiltrating in perivascular area of superficial and deep dermis and also periadnexal area,interstitial mucin deposition in the papillary and reticular dermis. Alzian blue staining and lupus band tests presented positive. Three cases were diagnosed as nodular cutaneous lupus mucinosis and the case 1 was also diagnosed as systemic lupus erythematosus. All the patients responded well to glucocorticosteroids and antimalarial agents.
引文
[1]Su X,Qiao X,Li J,et al.Papulonodular mucinosis,Guillain-Barrésyndrome and nephrotic syndrome in a patient with systemic lupus erythematosus:a case report[J].Bmc Nephrol,2017,18(1):43.
[2]Maruyama M,Miyauchi S,Hashimoto K.Massive cutaneous mucinosis associated with systemic lupus erythematosus[J].Br J Dermatol,1997,137(3):450-453.
[3]Desai S,Korta DZ,Patel RR,et al.Papulonodular mucinosis in a patient with systemic lupus erythematosus and antiphospholipid syndrome[J].J Drugs Dermatol,2014,13(5):621-623.
[4]Goerig R,Vogeler C,Keller M.Atypical presentation of cutaneous lupus mucinosis[J].J Clin Aesthet Dermatol,2013,6(4):37-40.
[5]Ausavarungnirun R,Srisuttiyakorn C.Papulonodular mucinosis in a suspected systemic lupus erythematosus patient[J].J Med Assoc Thai,2014,97(Suppl 2):S239-S242.
[6]Gouveia AI,Sousa M,Osóriovalente R,et al.Papulonodular mucinosis:an unusual presenting feature of systemic lupus erythematosus[J].Int J Dermatol,2016,55(11):e607-e608.
[7]Zander JEV,Shaw JC.Papular and nodular mucinosis as a presenting sign of progressive systemic sclerosis[J].J Am Acad Dermatol,2002,46(2):304-306.
[8]Sonntag M,Lehmann P,Megahed M,et al.Papulonodular mucinosis associated with subacute cutaneous lupus erythematosus[J].Dermatol,2003,206(4):326-329.
[9]Terao H,Moroi Y,Urabe K,et al.A case of nodular cutaneous lupus mucinosis[J].J Dermatol,2003,11(30):341-343.
[10]Obermoser G,Sontheimer RD,Zelger B.Overview of common,rare and atypical manifestations of cutaneous lupus erythematosus and histopathological correlates[J].Lupus,2010,19(9):1050.
[11]Rongioletti F,Rebora A.Cutaneous mucinoses:microscopic criteria for diagnosis[J].Am J Dermatopathol,2001,23(3):257-267.
[12]Elkeeb L,Spicknall KE,Mutasim DF.Nodular cutaneous mucinosis associated with systemic lupus erythematosus[J].Int J Dermatol,2014,53(11):1389-1391.
[13]Shekari AM,Ghiasi M,Ghasemi E,et al.Papulonodular mucinosis indicating systemic lupus erythematosus[J].Clin Exp Dermatol,2009,34(8):558-560.
[14]Sugiura K,Tanahashi K,Muro Y,et al.Cutaneous lupus mucinosis successfully treated with systemic corticosteroid and systemic tacrolimus combination therapy[J].J Am Acad Dermatol,2013,69(4):200-202.
[2]Maruyama M,Miyauchi S,Hashimoto K.Massive cutaneous mucinosis associated with systemic lupus erythematosus[J].Br J Dermatol,1997,137(3):450-453.
[3]Desai S,Korta DZ,Patel RR,et al.Papulonodular mucinosis in a patient with systemic lupus erythematosus and antiphospholipid syndrome[J].J Drugs Dermatol,2014,13(5):621-623.
[4]Goerig R,Vogeler C,Keller M.Atypical presentation of cutaneous lupus mucinosis[J].J Clin Aesthet Dermatol,2013,6(4):37-40.
[5]Ausavarungnirun R,Srisuttiyakorn C.Papulonodular mucinosis in a suspected systemic lupus erythematosus patient[J].J Med Assoc Thai,2014,97(Suppl 2):S239-S242.
[6]Gouveia AI,Sousa M,Osóriovalente R,et al.Papulonodular mucinosis:an unusual presenting feature of systemic lupus erythematosus[J].Int J Dermatol,2016,55(11):e607-e608.
[7]Zander JEV,Shaw JC.Papular and nodular mucinosis as a presenting sign of progressive systemic sclerosis[J].J Am Acad Dermatol,2002,46(2):304-306.
[8]Sonntag M,Lehmann P,Megahed M,et al.Papulonodular mucinosis associated with subacute cutaneous lupus erythematosus[J].Dermatol,2003,206(4):326-329.
[9]Terao H,Moroi Y,Urabe K,et al.A case of nodular cutaneous lupus mucinosis[J].J Dermatol,2003,11(30):341-343.
[10]Obermoser G,Sontheimer RD,Zelger B.Overview of common,rare and atypical manifestations of cutaneous lupus erythematosus and histopathological correlates[J].Lupus,2010,19(9):1050.
[11]Rongioletti F,Rebora A.Cutaneous mucinoses:microscopic criteria for diagnosis[J].Am J Dermatopathol,2001,23(3):257-267.
[12]Elkeeb L,Spicknall KE,Mutasim DF.Nodular cutaneous mucinosis associated with systemic lupus erythematosus[J].Int J Dermatol,2014,53(11):1389-1391.
[13]Shekari AM,Ghiasi M,Ghasemi E,et al.Papulonodular mucinosis indicating systemic lupus erythematosus[J].Clin Exp Dermatol,2009,34(8):558-560.
[14]Sugiura K,Tanahashi K,Muro Y,et al.Cutaneous lupus mucinosis successfully treated with systemic corticosteroid and systemic tacrolimus combination therapy[J].J Am Acad Dermatol,2013,69(4):200-202.