持久性隆起性红斑1例

报告持久性隆起性红斑1例。患者男，51岁，汕头人。面部、躯干、四肢关节伸侧出现紫红色结节、斑块伴轻度瘙痒1年半。皮肤组织病理示：表皮正常，真皮中、上部弥漫性嗜中性粒细胞浸润伴嗜酸性粒细胞和少许淋巴细胞，个别血管壁纤维蛋白样变性，血管壁及血管周可见嗜中性白细胞浸润、核尘及管外红细胞。诊断符合持久性隆起性红斑。     

手掌持久性隆起性红斑1例

报告1例手掌持久性隆起性红斑。患者男,74岁,双手掌结节6年。查体:双手掌及部分指关节屈侧大小不一隆起性结节,质硬,中央可见绿豆至黄豆大小溃疡。皮损组织病理:表皮轻度增生,皮突轻度下延,真皮浅层血管明显扩张充血,真皮全层胶原、纤维母细胞及血管明显增生,其间可见大量中性粒细胞及少量嗜酸性粒细胞浸润。诊断:持久性隆起性红斑。     

表现为血疱的持久性隆起性红斑1例

患者男,70岁。双手、足、肘、膝出现红斑、血疱6个月。皮损组织病理示:表皮下水疱,疱内可见大量嗜中性粒细胞,真皮内可见弥漫的嗜中性粒细胞浸润,血管管壁及管周可见纤维素样渗出及核碎裂。诊断:持久性隆起性红斑。临床医师应警惕以血疱为表现的持久性隆起性红斑。     

播散性浅表汗孔角化病并发寻常性银屑病

报告2例播散性浅表汗孔角化病并发寻常性银屑病.例1.男,53岁.头部、下肢红斑鳞屑3年,环形斑块1年.皮肤科检查:头皮鳞屑性红斑,面部、臀部散在边缘堤状隆起而中央轻度萎缩的褐色环状斑块.例2.男,37岁.全身红斑、鳞屑8年,环形斑块2年.皮肤科检查:头皮鳞屑性红斑,躯干、四肢鳞屑性红斑与边缘堤状隆起而中央轻度萎缩的褐色环状斑块混杂分布,两例患者红斑鳞屑性皮损经组织病理检查均符合寻常性银屑病,褐色环状斑块改变均见下方颗粒层消失的柱状角化不全,符合播散性浅表汗孔角化病.诊断:播散性浅表汗孔角化病并发寻常性银屑病.文中对银屑病并发汗孔角化病的可能原因进行了讨论.     

氨苯砜诱发运动神经末梢轴索的变性

近年来,氨苯砜已广泛使用在各种皮肤病的治疗上,由砜类药引起的严重副作用有溶血、正铁血红蛋白血症、中性白细胞减少和粒细胞缺乏症,此外尚有厌食、黄疸、皮疹、精神病和头痛。曾报道10例长期使用氨苯砜后引起多发性神经病变,主要是运动症状,特别是手内在肌的软弱与萎缩,也发现有感觉症状。肌电图检查发现手部肌肉有去神经的症状,而末稍感觉传递正常。本文报道1例患有持久性隆起性红斑的27岁女性患者,在连续氨苯砜治疗5年之后(近18个月     

氨苯砜治疗持久性隆起性红斑一例

患者，男，78岁。躯干、四肢多发紫红色结节、斑块伴疼痛3年。组织病理示:表皮间水肿，真皮浅中层弥漫性中性粒细胞浸润，血管壁界限不清，纤维组织增生。诊断为持久性隆起性红斑。治疗：氨苯砜100 mg每日一次口服，外用卤米松乳膏和夫西地酸乳膏，4个月后皮损明显好转。     

泛发性持久性隆起性红斑

报告1例全身泛发的持久性隆起性红斑.患者男,36岁.全身反复红色丘疹、水疱、结节伴瘙痒1年余.皮损组织病理示白细胞碎裂性血管炎.诊断:持久性隆起性红斑.     

持久性色素异常性红斑1例报告

持久性色素异常性红斑１例报告刘卫兵谷峡（山东省威海市四零四医院皮肤科２６２４００）患者，女性，５２岁。一年前无意中发现臀部有一块壹分硬币大小环形红斑，无感觉。红斑渐扩大，数目增多，伴轻痒感，中央退行性变伴色素沉着，边缘隆起角化发硬。曾先后诊为“体癣”...     

成人Still病1例

报告成人Still病1例。患者女，38岁，因四肢关节疼痛伴全身反复出现红斑、风团半年，初步诊断为荨麻疹性血管炎。皮损组织病理示：表皮轻度角化过度，可见棘层细胞轻度增生，真皮水肿、血管周围稀疏淋巴细胞浸润，可见散在分布的嗜酸粒细胞，未见明显白细胞碎裂。结合临床表现最后诊断为成人Still病。     

持久性隆起性红斑并发溃疡1例

持久性隆起性红斑是一种白细胞碎裂性血管炎,临床上不常见,诊断主要依靠临床表现、组织病理及免疫组织病理的结果.笔者诊治1 例伴有溃疡的持久性隆起性红斑患者,经治疗后溃疡已愈合,皮损基本消退,现报告如下.     

Erythema elevatum diutinum-a case successfully treated with colchicine

A case of erythema elevatum diutinum, unresponsive to dapsone but successfully treated with colchicine, is described.     

Alternative procedure to allow continuation of dapsone therapy despite serious adverse reaction in a case of dapsone-sensitive erythema elevatum diutinum

Dapsone has potent anti-inflammatory effects and remains an effective therapy in a variety of skin disorders: cutaneous vasculitis, neutrophilic dermatoses and blistering disorders. However it may cause a severe idiosyncratic reaction compatible with drug-induced DRESS (drug reaction with eosinophilia and systemic symptoms) leading to the discontinuation of the treatment despite its effectiveness. We report a 68-year-old woman who was successfully treated with dapsone for erythema elevatum diutinum. However she developed a hypersensitivity syndrome compatible with DRESS with fever, skin rash and acute hepatitis confirmed in vitro by the presence of circulating dapsone- specific T cells. Dapsone therapy was suspended, leading to a relapse of erythema elevatum diutinum. While alternative therapies were totally ineffective in our patient to improve her skin condition, we proposed a tolerance induction protocol to dapsone with excellent results.     

A case of erythema elevatum diutinum associated with peripheral ulcerative keratitis

A young woman with recurrent painful lesions on the dorsal aspects of her hands associated with arthralgia presented with pain and redness of both eyes. After extensive investigations, a diagnosis of erythema elevatum diutinum accompanied by peripheral ulcerative keratitis was made. The patient was treated with dapsone 50 mg, t.i.d., and responded well.     

Erythema elevatum diutinum with unusual clinical appearance

Erythema elevatum diutinum is a rare chronic inflammatory skin disease of unknown etiology with a histopathology of a leukocytoclastic vasculitis. Clinical findings involve symmetrical livid‐erythematous to red‐brown papules and plaques or nodules which are initially soft but become firmer. The skin lesions are located over extensor surfaces and often over joints. Early treatment with dapsone, corticosteroids and antibiotics is sometimes effective. A patient with multiple myeloma displayed unusual lesions of erythema elevatum diutinum.     

Erythema elevatum diutinum with rare distribution as a first clinical sign of non‐Hodgkin's lymphoma: A novel association?

We present a case of a 78-year-old man with erythema elevatum diutinum as a first clinical sign of non-Hodgkin's lymphoma. The patient developed erythema elevatum diutinum with an unusual distribution involving the trunk. Erythema elevatum diutinum is a rare dermatosis that is considered to be a localized, low-grade form of leukocytoclastic vasculitis associated with neoplastic, autoimmune and infectious processes. It is probably mediated by immune complexes. Recent studies report hematological disease as the most common factor associated with erythema elevatum diutinum. Many hematological diseases, such as myeloma, myelodysplastic syndrome and immunoglobulin (Ig)A monoclonal gammopathy, have been reported in association with erythema elevatum diutinum, but none with IgM monoclonal gammopathy and only one with malignant lymphoma. We would like to add IgM monoclonal gammopathy and non-Hodgkin's lymphoma as one of the diseases associated with erythema elevatum diutinum considering that the activity of erythema elevatum diutinum and non-Hodgkin's lymphoma fluctuated in parallel in the present case.     

Peripheral ulcerative keratitis associated with erythema elevatum diutinum and a positive rheumatoid factor: a report of three cases

Peripheral ulcerative keratitis (PUK) is a complication of collagen-vascular diseases such as rheumatoid arthritis (RA) and other systemic vasculitides. We report three cases of erythema elevatum diutinum with PUK. These patients presented with nodules and plaques consistent with erythema elevatum diutinum on the extremities and crusted or ulcerated purpuric lesions on the soles. Histopathological examination of these lesions revealed a dense neutrophilic infiltrate with nuclear dust and fibrin around blood vessels. All the patients developed PUK concomitant with the development of the skin lesions. The rheumatoid factor was positive at high titre in all three patients; this was associated with probable RA in one. Cutaneous lesions were dramatically improved by administration of dapsone in all cases. Dapsone was also effective in treating the ocular lesions in two patients.     

Erythema elevatum diutinum developing squamous cell carcinoma.

After a 25-year history of erythema elevatum diutinum involving the extremities and later the face and the buttocks in a 70-year-old Japanese man, squamous cell carcinoma developed from one of the lesions on the right foot. Histological examination of erythema elevatum diutinum revealed leukocytoclastic angiitis of the upper dermal vessels and perivascular fibrosis. DDS was not effective for erythema elevatum diutinum.     

Unique aspects of a lesion of erythema elevatum diutinum

A 70-year-old man with erythema elevatum diutinum developed new lesions on his right hand 4 years after initiation of treatment with dapsone. An unusual protruberant appearance of these lesions grossly and a peculiar fibrosing quality histopathologically of one lesion are features that, to our knowledge, have not been reported previously.     

Antineutrophil cytoplasmic antibodies of IgA class in neutrophilic dermatoses with emphasis on erythema elevatum diutinum

OBJECTIVE: To evaluate the prevalence of IgA and IgG antineutrophil cytoplasmic antibodies (ANCAs) in erythema elevatum diutinum in comparison with 2 other groups of neutrophilic dermatoses: Sweet syndrome and pyoderma gangrenosum. DESIGN: Detection of IgA and IgG ANCAs in the serum of patients with neutrophilic dermatoses and characterization of the previously known antigenic targets. SETTING: All serum was analyzed without knowledge of diagnosis in the Immunology Department, Pitié-Salpêtrière Hospital, Paris, France. PATIENTS: Ten patients with erythema elevatum diutinum, 10 with Sweet syndrome, 10 with pyoderma gangrenosum, and 10 healthy volunteers. MAIN OUTCOME MEASURES: IgA and IgG ANCAs were sought by indirect immunofluorescence with ethanol and formaldehyde-fixed human neutrophil preparations as the substrate. Enzyme-linked immunosorbent assays were further performed for antigen characterization. RESULTS: IgA ANCAs were observed in 60% and IgG ANCAs in 10 (33%) of the patients. All patients with erythema elevatum diutinum had IgA ANCAs. IgA fluorescence in formaldehyde-fixed neutrophils was restricted to those from patients with erythema elevatum diutinum. Enzyme-linked immunosorbent assays disclosed no single predominant target, and antigens remained largely undetermined in erythema elevatum diutinum. CONCLUSIONS: The ANCAs, particularly of IgA class, may prove to be a helpful paraclinical marker in erythema elevatum diutinum and an interesting perspective for understanding the pathophysiology of the disease. The nature of the unidentified targets and the pathogenicity of ANCAs, however, remain to be assessed.