抗JO-1抗体阳性的男性播散性盘状红斑狼疮1例
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摘要
患者男,46岁。头皮、颜面部、肩颈部、双上肢多发红斑上覆黏着性鳞屑1年。皮肤科情况:头皮、双面颊、鼻背、额、耳轮、肩颈部、双上肢见多发大小不等暗红色丘疹或盘状斑块,双面颊皮损融合成片,表面附有灰白色黏着性鳞屑。皮损组织病理示:角化过度,毛囊角栓,表皮轻度萎缩,基底细胞液化变性,真皮浅层多少不等的淋巴细胞浸润,可见多量噬色素细胞,毛囊及汗腺周围淋巴细胞浸润。实验室检查:ANA阳性,抗JO-1抗体阳性。诊断:播散性盘状红斑狼疮。治疗:患者经硫酸羟氯喹片、泼尼松片、地奈德乳膏治疗病情缓解。
A 46-year-old male had multiple erythematous plaques covered with adherent scales,which involved the scalp,face,shoulders,neck and arms for one year. Dermatological examination revealed many dark red papules or discoid plaque with greyish adherent scales,which distributed in different sizes on the scalp,cheeks,nose,forehead,ears,shoulder,neck and upper arms. Remarkably,lesions on both cheeks could coalesced into widespread plaques. Histopathological findings in lesional skin included hyperkeratosis,follicular plugging,mild epidermal atrophy,liquefactive basal cell degeneration,dermal lymphocytic infiltrates,which accompanied by a number of melanophages,lymphocytic infiltrates around the hair follicles and eccrine glands. Laboratory testing showed that antinuclear antibody(ANA) and anti-JO-1 antibody were positive. Therefore,he was diagnosed as disseminated discoid lupus erythematosus. All the lesions had significant improvements after administrated with hydroxychloroquine,prednisone and topical desonide.
A 46-year-old male had multiple erythematous plaques covered with adherent scales,which involved the scalp,face,shoulders,neck and arms for one year. Dermatological examination revealed many dark red papules or discoid plaque with greyish adherent scales,which distributed in different sizes on the scalp,cheeks,nose,forehead,ears,shoulder,neck and upper arms. Remarkably,lesions on both cheeks could coalesced into widespread plaques. Histopathological findings in lesional skin included hyperkeratosis,follicular plugging,mild epidermal atrophy,liquefactive basal cell degeneration,dermal lymphocytic infiltrates,which accompanied by a number of melanophages,lymphocytic infiltrates around the hair follicles and eccrine glands. Laboratory testing showed that antinuclear antibody(ANA) and anti-JO-1 antibody were positive. Therefore,he was diagnosed as disseminated discoid lupus erythematosus. All the lesions had significant improvements after administrated with hydroxychloroquine,prednisone and topical desonide.
引文
[1]赵辨.中国临床皮肤病学[M].2版.南京:江苏科学技术出版社,2017:833.
[2]Hirakata M,Nagai S.Interstitial lung disease in poly-myositis and dermatomyositis[J].Current Opinion in Rheumatol,2000,12(5):501-508.
[3]Bohan A,Peter JB.Polymyositis and dermatomyositis[J].N Engl J Med,1975,292(7):344-347.
[4]Ascherman D.Characterization of Jo1 specific T cell proliferative responses in polymyositis[J].Arthritis Rheum,2001,26(3):1262.
[5]王云霞,方琪,李旺俊,等.血清抗Jo-1抗体和抗核抗体与多发性肌炎患者心、肺损害的关系[J].临床神经病学杂志,2010,23(3):214-215.
[6]陈豪,江涛,周密,等.皮肌炎/多发性肌炎并发肺部疾病的临床分析[J].重庆医科大学学报,2015,40(12):1546-1549.
[7]李虎羽,张江安,于建斌,等.儿童盘状红斑狼疮1例[J].中国皮肤性病学杂志,2014,28(6):651,653.
[8]Wollina U,Looks A.Extracorporeal photochemotherapy in cutaneous lupus erythematosus[J].J Eur Acad Dermatol Venereol,1999,13(2):127-130.
[2]Hirakata M,Nagai S.Interstitial lung disease in poly-myositis and dermatomyositis[J].Current Opinion in Rheumatol,2000,12(5):501-508.
[3]Bohan A,Peter JB.Polymyositis and dermatomyositis[J].N Engl J Med,1975,292(7):344-347.
[4]Ascherman D.Characterization of Jo1 specific T cell proliferative responses in polymyositis[J].Arthritis Rheum,2001,26(3):1262.
[5]王云霞,方琪,李旺俊,等.血清抗Jo-1抗体和抗核抗体与多发性肌炎患者心、肺损害的关系[J].临床神经病学杂志,2010,23(3):214-215.
[6]陈豪,江涛,周密,等.皮肌炎/多发性肌炎并发肺部疾病的临床分析[J].重庆医科大学学报,2015,40(12):1546-1549.
[7]李虎羽,张江安,于建斌,等.儿童盘状红斑狼疮1例[J].中国皮肤性病学杂志,2014,28(6):651,653.
[8]Wollina U,Looks A.Extracorporeal photochemotherapy in cutaneous lupus erythematosus[J].J Eur Acad Dermatol Venereol,1999,13(2):127-130.