色素性痒疹2例

报告2例色素性痒疹.例1为女性,26岁.颈部、胸腹部、背部出现淡红色丘疹伴剧烈瘙痒1年.皮损反复发作,消退后遗留网状色素沉着斑.例2为男性,17岁.颈、胸、背部出现红色丘疹及网状色素沉着伴剧烈瘙痒半年,皮损呈风团样,反复发作.2例患者皮损组织病理检查结果均显示非特异性苔藓样皮炎改变.经口服米诺环素200mg/d治疗3周后,2例患者红色丘疹均完全消退,瘙痒消失,原皮损部位遗留网状色素沉着斑,随访2个月无复发.     

色素性痒疹1例

报告1例色素性痒疹。患者女,19岁,学生。因颈项、躯干部反复起红色丘疹伴剧烈瘙痒4年余而就诊,病情夏季加重。体查示颈项、腰背部、前胸、上腹部见网状排列的红斑、风团样丘疹,周围伴有褐色色素沉着斑。组织病理示非特异性苔藓样组织反应。诊断:色素性痒疹。给予口服米诺环素100 mg,一天两次治疗,1周后皮疹完全消退,瘙痒消失,原皮损部位遗留网状色素沉着斑;改口服米诺环素50 mg,一天两次,继续治疗两周,随访3个月无复发。     

色素性痒疹1例

报告1例色素性痒疹。患者女,19岁,学生。因颈项、躯干部反复起红色丘疹伴剧烈瘙痒4年余而就诊,病情夏季加重。体查示颈项、腰背部、前胸、上腹部见网状排列的红斑、风团样丘疹,周围伴有褐色色素沉着斑。组织病理示非特异性苔藓样组织反应。诊断：色素性痒疹。给予口服米诺环素100 mg,一天两次治疗,1周后皮疹完全消退,瘙痒消失,原皮损部位遗留网状色素沉着斑;改口服米诺环素50 mg,一天两次,继续治疗两周,随访3个月无复发。     

色素性痒疹1例

报告色素性痒疹1例。患者女,27岁,腰背部红斑、丘疹、网状色素沉着伴剧烈瘙痒2月余。皮肤科检查:腰背部可见大片褐色网状色素沉着斑,左侧腰部可见色素沉着区域周围散在新发米粒至黄豆大小红色丘疹、斑片,局部表面覆以少许血痂。病理检查:表皮网篮状角化,表皮下水疱形成,基底细胞液化变性,可见棘层细胞内水肿,表皮真皮交界处及表皮局灶伴少量淋巴细胞浸润。诊断:色素性痒疹。治疗上予以米诺环素100 mg/d,每日两次口服,治疗2周后好转停药,随访两月,皮疹未见复发。     

色素性痒疹1例

报告1例色素性痒疹。患者女,18岁,上肢、胸前、腰背部皮疹伴瘙痒4年。皮肤专科检查:腰背部、上肢、胸前部可见片状暗褐色色素沉着斑,相互融合成网状,其间及边缘可见少许散在淡红色丘疹、丘疱疹,无明显鳞屑,无毛细血管扩张。腰背部皮损组织病理示:表皮轻度增生,棘细胞间轻度水肿,基底细胞灶区空泡化变性,真皮浅层血管周围淋巴细胞及中性粒细胞为主浸润,并见噬黑素细胞及色素颗粒。根据临床特征及病理检查,诊断:色素性痒疹。治疗:予盐酸多西环素肠溶胶囊100 mg,每日2次口服,治疗一周后患者觉瘙痒减轻,原红色皮疹转暗红色。后继续给予多西环素口服2周,每次100 mg,每日2次。患者最后失访。     

色素性痒疹1例

患者,男,21岁。颈部、胸背部红斑、丘疹、水疱伴瘙痒2年。组织病理示海绵水肿性皮炎。结合临床诊断为色素性痒疹。     

色素性痒疹1例

报告色素性痒疹1例．患者女，35岁，因背部出现丘疹、色素斑伴剧烈瘙痒1年。皮损组织病理检查示：表皮轻度角化不全，部分棘细胞片状水肿，见个别坏死角质形成细胞，基底层细胞液化变性、色素失禁，淋巴细胞浸润表皮，真皮浅层淋巴细胞浸润。结合临床表现诊断为色素性痒疹。     

色素性痒疹1例

报告1例色素性痒疹。患者女,21岁,背部褐色斑疹伴瘙痒3年。查体:背部、肩部可见大片褐色色素沉着斑,褐色斑中间及边缘夹杂暗红色斑疹,相互融合成网状,表面轻微鳞屑,无萎缩及毛细血管扩张。皮损病理检查:角化正常,棘层肥厚,局灶性海绵水肿及水疱形成,局灶基底部液化变性,真皮浅层血管周围少量淋巴细胞浸润,伴少量噬色素细胞增生。根据临床表现及皮损组织病理,诊断为色素性痒疹。治疗:口服米诺环素200 mg/d。2周后,患者瘙痒症状消失,背部、肩部暗红色斑疹消退,遗留褐色网状色素沉着。遂改为米诺环素100 mg/d口服,巩固治疗2周。     

色素性痒疹1例

患者女,24岁。前胸和上背部起瘙痒性丘疹2年半,皮损反复发作,逐渐融合成网状,消退后遗留色素沉着。皮损组织病理示:表皮轻度棘层肥厚,海绵形成,基底细胞灶状液化变性,真皮浅层血管周围单一核细胞浸润,散在噬黑素细胞。诊断:色素性痒疹。给予米诺环素100mg/d,1周后瘙痒消失,红色丘疹基本消退,遗留网状色素沉着斑。     

色素性痒疹

报告1例色素性痒疹。患者男,27岁。肩背部反复红斑伴瘙痒6年,加重1个月。皮肤科检查:颈部、肩背部及上肢伸侧近端可见对称分布的片状红色斑丘疹,表面光滑无鳞屑,部分融合成网状,其间有斑状色素沉着。皮损组织病理检查:表皮大致正常,棘层浅部见大量角化不良细胞,基底细胞液化变性,真皮浅层淋巴细胞及中性粒细胞呈苔藓样浸润,散在噬色素细胞。诊断:色素性痒疹。     

Pruritic eruption with reticular pigmentation: confluent and reticulate papillomatosis

A 28-year-old man presented with a 2-year history of a pruritic eruption on his neck, chest, back, axillae, and antecubital and pubic areas. The patient had been previously treated with topical and systemic antifungal therapy for a long time, but showed no response. Examination revealed the typical clinical and histological features of confluent and reticulate papillomatosis. The patient responded well to oral doxycycline.     

Vesiculous prurigo pigmentosa in a 13-year-old girl: good response to isotretinoin

Prurigo pigmentosa is a rare inflammatory disease of unknown origin, first reported from Japan, with only 33 cases described in non-Japanese patients. We describe a 13-year-old girl with a pruriginous symmetrical eruption of papules and vesicles affecting her back, neck and chest of 1 month duration. She remembered a similar, but lighter eruption, 2 months before. As the initial diagnosis was of a vesiculobullous form of Darier disease, treatment with isotretinoin 40 mg/day was started with good response. Histological study showed a superficial perivascular and interstitial dermatitis composed predominantly of lymphocytes. The epidermis was spongiotic, with exocytosis of lymphocytes and some neutrophils and necrotic keratinocytes. All these findings were consistent with prurigo pigmentosa. The lesions resolved leaving a light brown reticulate hyperpigmentation. Prurigo pigmentosa has never been reported in prepubescent patients, the vesiculobullous forms are unusual, and the only treatments used previously are sulphonamides, tetracyclines and macrolides. We report a 13-year-old Caucasian girl with vesiculobullous prurigo pigmentosa successfully treated with isotretinoin.     

Dowling-Degos disease--a heat aggravated variant

A 22-year-old woman presented with a 5-year history of a micropapular eruption localized to the flexor aspect of her limbs as well as persistent reticulate pigmentation of her neck and upper chest resembling Darier's disease. The eruption was associated with pruritus that was precipitated by heat and was worse in summer. The axillae, groins and inframammary areas had multiple papules but lacked reticulate pigmentation. Multiple biopsies showed an epidermis with club- and antler-like rete ridges but no acantholysis or dyskeratosis. This distinct clinical presentation may represent an unusual heat aggravated variant of Dowling-Degos disease that clinically shares features with Darier's disease and transient acantholytic dermatosis.     

Adult-onset Still's disease with prurigo pigmentosa-like skin eruption

A 34-year-old woman with adult-onset Still's disease (AOSD) developed prurigo pigmentosa-like lesions on her chest and upper back in addition to the typical rash of AOSD. A biopsy specimen taken from the upper back showed characteristic features of prurigo pigmentosa. The eruption and fever subsided immediately after the administration of 40 mg/day prednisolone, but arthralgia persisted even after intravenous pulse methylprednisolone therapy in combination with immunosuppressive drugs. Various atypical skin rashes, including prurigo pigmentosa-like lesions, have been reported in association with AOSD. Therefore, one should carefully follow the clinical course of a patient in order not to overlook these atypical cutaneous manifestations of AOSD.     

特发性发疹性斑状色素沉着症

报告1例特发性发疹性斑状色素沉着症.患者男,27岁.因背部、胸部出现浅灰色色素沉着斑1个月余就诊.否认发病前有炎症性皮肤病史,无用药史.皮肤科检查:背部、胸部散在直径0.5～2.5 cm浅灰色色素沉着斑,呈均匀一致的细网纹状,皮损境界大致清楚,互不融合,表面光滑无鳞屑.皮损组织病理检查:基底层黑素增多,基膜完整,未见细胞空泡化变性,真皮有较多噬黑素细胞.4个月后随访,约75%色素斑已消退或颜色变淡.诊断:特发性发疹性斑状色素沉着症.     

Keratosis lichenoides chronica: marked response to calcipotriol ointment

Keratosis lichenoides chronica (KCL) is a rare dermatosis characterized by a distinctive seborrheic dermatitis-like facial eruption, together with violaceous, papular, and nodular lesions on the extremities and trunk, typically arranged in a linear and reticulate pattern. KLC is resistant to therapy, although spontaneous remission has been reported. We describe a 35-year-old woman with KLC who had the typical features of widespread violaceous, reticulate, and striae-like eruptions with a prominent keratotic component over a nine-year period and who responded well to treatment with calcipotriol ointment. The immunohistochemical profiles are presented in addition to typical histopathologic features.     

Prurigo pigmentosa

A 22-year-old Chinese woman presented with a 5-year history of an intensely pruritic eruption on her posterior neck, mid back and sacrum leaving reticulate pigmentation. The diagnosis of prurigo pigmentosa was made on the basis of the clinico-histological features and a response to minocycline. Although prurigo pigmentosa is uncommon, it has characteristic clinical and histological features. Early diagnosis and appropriate treatment result in a rapid response and prevents a progression of pigmentation.     

Lichenoid eruption due to mercaptopropionylglycine

Two patients with lichenoid eruption due to mercaptopropionylglycine (MPG) are reported. Case 1 was a 63-year-old woman, who developed a pruritic eruption after oral ingestion of MPG 600 mg/day for a month and a half. The clinicopathological findings were a lichenoid reaction. She also showed diffuse alopecia, which has not been reported as a side effect of this drug. Case 2 was a 71-year-old man who developed discoid lupus erythematosus-like lesions after oral MPG 200 mg/day for two months, but the histological findings were a lichenoid reaction. In both patients, the lesions disappeared rapidly after discontinuing the drug. The eruption was reproduced by readministrating MPG in case 1. The skin reaction in both patients seemed to be the cell-mediated immune reaction to MPG.     

获得性复发性自愈性Blaschko皮炎

报告1例获得性复发性自愈性Blaschko皮炎.患者男,41岁.右胸背部反复出现丘疱疹伴剧烈瘙痒20余年.组织病理示海绵水肿性皮炎.结合临床和组织病理诊断为获得性复发性自愈性Blaschko皮炎.     

Behçet's disease

A 29-year-old man presented with oral and genital ulcers, erythematous papules and pustules on his back and chest, and deep vein thrombi. A diagnosis of Beh?et disease was made. Beh?et disease is a relapsing disorder that affects the mucocutaneous surfaces. It presents usually as ulcers on the orogenital mucosae, but can also present as an acneiform eruption. The International Study Group on Beh?et disease has established criteria that consist of oral and genital lesions, ocular involvement, skin findings, and a pathergy. Treatment of choice is colchicine or prednisone.