皮肤淋巴细胞浸润症一例
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摘要
患者,女,46岁。鼻根部肿胀性红斑2年,伴双眼睑水肿及双侧耳前皮下肿块20天。查体可见患者鼻背部及左侧下眼睑蚕豆大淡红色浸润性红斑,与周围正常皮肤界限不清,双侧耳前可触及花生大质硬椭圆形肿块。皮肤组织病理示(鼻根部):表皮轻度角化亢进,真皮层毛囊及皮脂腺周围可见较多淋巴细胞浸润。免疫组化染色显示:CD2(+),CD3(+),CD7(+),CD20(+),CD30(-),CD56(-),CD4(+),CD8(+),Ki67(10%+),EBER(-),提示浸润细胞以T淋巴细胞为主,伴少量B淋巴细胞。诊断:Jessner皮肤淋巴细胞浸润症。
A 46-year-old female presented with infiltrated erythematous plaques on the nasal root for 2 years and prominent swelling of the left eyelid and bilateral preauricular area for 20 days. Skin biopsy on the nose root revealed a dense lymphocytic infiltrate of dermis with perivascular and perifollicular distribution. Immunohistochemical analysis revealed CD2(+),CD3(+),CD7(+),CD20(+),CD30(-),CD56(-),CD4(+),CD8(+),Ki67(10%+),EBER(-), indicating that the infiltrate was predominantly composed of mature T lymphocytes and a few B lymphocytes. The diagnosis of Jessner's lymphocytic infiltration was made.
A 46-year-old female presented with infiltrated erythematous plaques on the nasal root for 2 years and prominent swelling of the left eyelid and bilateral preauricular area for 20 days. Skin biopsy on the nose root revealed a dense lymphocytic infiltrate of dermis with perivascular and perifollicular distribution. Immunohistochemical analysis revealed CD2(+),CD3(+),CD7(+),CD20(+),CD30(-),CD56(-),CD4(+),CD8(+),Ki67(10%+),EBER(-), indicating that the infiltrate was predominantly composed of mature T lymphocytes and a few B lymphocytes. The diagnosis of Jessner's lymphocytic infiltration was made.
引文
[1] 张雪洁, 李琨, 边培雯,等. 皮肤淋巴细胞浸润症一例[J]. 中国麻风皮肤病杂志, 2016, 32(9):555.
[2] Engin B, Songür A, Kutlubay Z, et al. Lymphocytic infiltrations of face[J]. Clin Dermatol,2014,32(1):101-108.
[3] Poenitz N, Dippel E, Klemke CD, et al. Jessner's lymphocytic infiltration of the skin: a CD8+ polyclonal reactive skin condition[J]. Dermatology, 2003, 207(3):276-284.
[4] Rijlaarsdam JU, Nieboer C, De VE, et al. Characterization of the dermal infiltrates in Jessner's lymphocytic infiltrate of the skin, polymorphous light eruption and cutaneous lupus erythematosus: differential diagnostic and pathogenetic aspects[J]. J Cutan Patho,2010,17(1):2-8.
[5] 颜晓波, 曲才杰, 毕健平. 10例肿胀性红斑狼疮临床及病理分析[J]. 中国麻风皮肤病杂志,2017,33(3):159-161.
[6] 胡瑜霞, 杨绪娟, 农祥. 多形性日光疹发病机制的研究[J]. 临床皮肤科杂志,2017(2):139-141.
[7] 熊喜喜, 鲁严. 皮肤假性淋巴瘤的研究进展[J]. 国际皮肤性病学杂志,2016,42(6):457-460.
[8] Lipsker D, Mitschler A, Grosshans E, et al. Could Jessner's lymphocytic infiltrate of the skin be a dermal variant of lupus erythematosus an analysis of 210 cases[J]. Dermatology,2006,213(1):15-22.
[9] Toonstra J, Wildschut A, Boer J, et al. Jessner's lymphocytic infiltration of the skin. A clinical study of 100 patients[J]. Arch Dermatol,1989,125(11):1525-1530.
[10] Guillaume JC, Moulin G, Dieng MT, et al. Crossover study of thalidomide vs placebo in Jessner's lymphocytic infiltration of the skin[J]. Arch Dermatol,1995,131(9):1032.
[11] Seo JW, Kim TH, Choi SH, et al. Successful treatment of Jesnner's lymphocytic infiltration of the skin with methotrexate[J]. Korean J Dermatol,2017,55(2):143-145.
[12] Conti R, Bassi A, Lorenzoni E, et al. Jessner-Kanof disease: two effective and sure therapeutic options[J]. Dermatol Ther,2013,26(4):373-376.
[2] Engin B, Songür A, Kutlubay Z, et al. Lymphocytic infiltrations of face[J]. Clin Dermatol,2014,32(1):101-108.
[3] Poenitz N, Dippel E, Klemke CD, et al. Jessner's lymphocytic infiltration of the skin: a CD8+ polyclonal reactive skin condition[J]. Dermatology, 2003, 207(3):276-284.
[4] Rijlaarsdam JU, Nieboer C, De VE, et al. Characterization of the dermal infiltrates in Jessner's lymphocytic infiltrate of the skin, polymorphous light eruption and cutaneous lupus erythematosus: differential diagnostic and pathogenetic aspects[J]. J Cutan Patho,2010,17(1):2-8.
[5] 颜晓波, 曲才杰, 毕健平. 10例肿胀性红斑狼疮临床及病理分析[J]. 中国麻风皮肤病杂志,2017,33(3):159-161.
[6] 胡瑜霞, 杨绪娟, 农祥. 多形性日光疹发病机制的研究[J]. 临床皮肤科杂志,2017(2):139-141.
[7] 熊喜喜, 鲁严. 皮肤假性淋巴瘤的研究进展[J]. 国际皮肤性病学杂志,2016,42(6):457-460.
[8] Lipsker D, Mitschler A, Grosshans E, et al. Could Jessner's lymphocytic infiltrate of the skin be a dermal variant of lupus erythematosus an analysis of 210 cases[J]. Dermatology,2006,213(1):15-22.
[9] Toonstra J, Wildschut A, Boer J, et al. Jessner's lymphocytic infiltration of the skin. A clinical study of 100 patients[J]. Arch Dermatol,1989,125(11):1525-1530.
[10] Guillaume JC, Moulin G, Dieng MT, et al. Crossover study of thalidomide vs placebo in Jessner's lymphocytic infiltration of the skin[J]. Arch Dermatol,1995,131(9):1032.
[11] Seo JW, Kim TH, Choi SH, et al. Successful treatment of Jesnner's lymphocytic infiltration of the skin with methotrexate[J]. Korean J Dermatol,2017,55(2):143-145.
[12] Conti R, Bassi A, Lorenzoni E, et al. Jessner-Kanof disease: two effective and sure therapeutic options[J]. Dermatol Ther,2013,26(4):373-376.