泛发性肥厚性扁平苔藓1例

报告泛发性肥厚性扁平苔藓1例。患者男,76岁,全身泛发紫红色丘疹、斑块伴瘙痒3月余。皮肤科检查:躯干、四肢泛发紫红色增殖性肥厚性斑块,部分呈疣状外观,面部、头皮、手掌弥漫性紫红色斑疹,口腔颊黏膜可见Wickham纹,龟头可见一暗紫红色斑,双足底皮肤增厚、皲裂。右大腿皮损组织病理符合扁平苔藓。诊断:泛发性肥厚性扁平苔藓。患者既往规律抗结核治疗7个月余,且免疫指标异常,考虑皮疹可能与抗结核药物及免疫异常有关,调整药物治疗后皮疹好转。     

紫杉醇致扁平苔藓样药疹1例

患者女,62岁,双下肢红斑、丘疹伴痒2个月,加重伴全身泛发1个月。躯干及四肢弥漫性红斑、丘疹,上覆少量鳞屑,伴双侧颊黏膜的破溃。发疹前8个月右侧"乳腺恶性肿瘤切除术"后行紫杉醇化疗半年余。皮损组织病理示:表皮角化不全,毛囊角栓,棘层肥厚,基底细胞液化,可见坏死角质形成细胞,真皮血管周围大量淋巴细胞、少数嗜酸性粒细胞浸润。直接免疫荧光:IgG(-),IgA(-),C_3(-)。诊断:扁平苔藓样药疹。     

抗结核药物诱发扁平苔藓1例

 报告抗结核药物诱发扁平苔藓1例。患者男,68岁。因周身暗红色皮疹伴瘙痒2个月余就诊。患者“肺结核（活动期）”病史5个月,规律抗结核治疗3个月后,面颈部、躯干及四肢出现密集分布的绿豆至黄豆大小发青、发紫斑丘疹、斑片,伴干燥、脱屑、瘙痒,皮损组织病理提示符合扁平苔藓样药疹。临床诊断为扁平苔藓样药疹,予以调节免疫、抗组胺及外用药物等对症处理,病情好转。抗结核药物引起的扁平苔藓样药疹临床上较少见,需注意鉴别。     

线状扁平苔藓合并色素性扁平苔藓1例

患者男,28岁。额部褐色斑片10个月,左腰部及右前臂丘疹6个月。皮肤科情况:额部弥漫性褐色斑片,左腰部及右前臂可见线状分布的绿豆至黄豆大小紫红色和褐色多角形扁平丘疹,部分融合,其上覆少许白色鳞屑,口腔黏膜及指(趾)甲无异常。左腰部皮损组织病理示:表皮角化过度,基底细胞液化变性,真皮浅层致密淋巴细胞带状浸润。额部皮损组织病理示:表皮轻度萎缩,基底细胞灶状空泡化,真皮浅中层小血管及部分皮肤附属器周围中等量淋巴细胞、散在噬色素细胞浸润。诊断:线状扁平苔藓合并色素性扁平苔藓。     

泛发性肥厚性扁平苔藓1例

患者男,59岁,全身起皮疹伴瘙痒3个月。查体:全身泛发性肥厚性增殖性斑块,部分呈疣状外观,表面覆有白色鳞屑,不易刮除,龟头可见一暗紫红色斑片,两侧口腔颊黏膜可见暗紫色斑片,两手掌、足底可见散在分布黄色角化性斑块。皮肤组织病理提示为扁平苔藓。诊断:泛发性肥厚性扁平苔藓。患者既往规律抗结核治疗7个月,停用抗结核药物后皮疹减轻,考虑可能与抗结核药物有关。     

寻常型银屑病伴扁平苔藓1例

1临床资料 患者男,55岁。因右下肢紫红色扁平丘疹伴瘙痒1yr半而就诊。患者有“寻常型银屑病”病史20yr。每年全身皮肤均反复出现红丘疹、斑丘疹,表面覆白色鳞屑,伴轻度瘙痒。每次经治疗后皮损可大部分好转或部分清退,1．5yr前无明显诱因于右火腿内侧根部皮肤出现多个紫红色扁平丘疹,表面覆薄层白色鳞屑,自觉瘙痒。之后皮损逐渐增多,并扩散至小腿内侧直达右足内踝处,呈带状分布。口腔黏膜未受累。外搽“复方咪糠唑乳膏”后皮损有所消退。近2m来皮损再次增多而到我料就诊。患者既往健康。否认家庭中类似皮肤病史。体检：系统检查无异常。皮肤科情况：头皮、躯干、四肢、臀部皮肤见散在分布绿豆至钱币大小淡红色丘疹及斑丘疹,上面覆干燥银白色鳞屑,刮去鳞屑可见到薄膜,刮去薄膜可见到点状出血。右下肢内侧腹股沟至足内踝皮肤见呈带状分布的紫红色扁甲圆形丘疹,表面附有一层光滑发亮的蜡样薄膜鳞屑,鳞屑不易刮除。口腔黏膜无白色斑点、糜烂等损害。实验室检查：血、尿常规,肝、肾功能,X线胸片,腹部B超,心电图无异常。取右大腿内侧皮损行组织病理检查示：     

扁平苔藓样类天疱疮1例

患者男,25岁。全身皮疹伴瘙痒2个月。皮肤科情况:双侧颊黏膜见网状白斑,躯干、四肢可见散在大小不等的暗紫红色斑疹、斑丘疹,部分皮疹表面见细小鳞屑,可见Wickham纹,全身见较多散在分布的糜烂、结痂,双侧前臂、手足背部少许散在分布的紧张性水疱,尼氏征阴性。组织病理及免疫荧光检查符合扁平苔藓样类天疱疮的诊断。给予地塞米松5 mg/d抗炎,钙剂、抗组胺药止痒,激素药膏局部外涂等对症处理,患者皮损明显好转。     

泛发性扁平苔藓一例

患儿男,16岁。2个月前无明显诱因,上肢、躯干出现暗红色丘疹,高出皮面,伴瘙痒,皮疹逐渐增多。发疹前无明确用药史。既往体健,否认家族有类似疾病患者。体检：各系统检查未见异常。皮肤科检查：皮疹泛发,以双上肢、胸腹部、背部为主,皮损表现为米粒至绿豆大小暗红色丘疹,部分融合倾向,可见同形反应（图1,2）。甲、唇及口腔黏膜未见损害。腹部皮损组织病理：表皮角化过度,颗粒层呈楔形增厚,棘层增厚,基底细胞液化变性,真皮浅层单一核细胞为主的炎症细胞呈带状分布（图3）。诊断：泛发性扁平苔藓……     

副肿瘤性天疱疮1例

<正>患者女,62岁。因口腔溃疡4个月,全身紫红色斑丘疹1周于2007年8月15日就诊于我科门诊,门诊拟诊"扁平苔藓?副肿瘤性天疱疮?"收住院。患者4个月前无明显诱因下出现口腔破溃,伴明显疼痛,当地医院给予消炎等对症处理没有好转,且进行性加重。近1周全身皮肤逐渐出现紫红色斑丘疹,伴剧烈瘙痒。     

持久性发疹性斑状毛细血管扩张症伴色素性荨麻疹1例

目的:报告1例持久性发疹性斑状毛细血管扩张症伴色素性荨麻疹。患者男,48岁。颈、躯干及四肢出现丘疹、斑丘疹4年余。皮肤科检查:颈、前胸及四肢可见红褐色丘疹、斑丘疹,间杂散在毛细血管扩张;背部可见褐色丘疹,摩擦后出现风团(Diarer征阳性)。皮损组织病理:表皮大致正常,真皮浅层毛细血管扩张,有单一核细胞浸润;Giemsa染色:真皮浅层肥大细胞浸润。诊断为持久性发疹性斑状毛细血管扩张症伴色素性荨麻疹。     

Palmoplantar lichen planus presenting with vesicle-like papules

Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. Although several morphological patterns may be seen, plaques or small papules with compact hyperkeratosis are usually observed. We present a 25-year-old woman with a one-month history of slightly pruritic, red papules on her palms and soles. Dermatologic examination revealed numerous, asymptomatic, unscaly, red papules on her palms and soles, some of them resembling vesicles and white reticulate plaques on both sides of the buccal mucosa. The diagnosis was established by the typical histopathological features of lichen planus. Although resistant to topical corticosteroids, she responded well to systemic corticosteroid therapy, and no recurrence was observed during the follow-up period of one year.     

呈网状红斑改变的扁平苔藓

报告1例呈网状红斑改变的扁平苔藓。患者女,34岁。全身泛发网状红斑22年,伴瘙痒,有口腔黏膜及甲受累。皮肤科检查见全身泛发网状红斑,部分红斑消退后局部有轻度萎缩,散在水疱,尼氏征阴性。双手多个指甲甲板萎缩、吸收。上腭见片状糜烂面。组织病理检查示表皮变薄,基底细胞广泛液化变性,真皮浅层淋巴细胞呈带状浸润。诊断：扁平苔藓。给予阿维A40mg/d口服3个月后皮损明显变平,颜色变暗。     

The diagnostic significance of immunoglobulin and fibrin deposition in lichen planus

Direct immunofluorescent (IF) staining was performed on biopsy specimens from fifty-three patients with active lichen planus. In fifteen of these cases uninvolved skin sites were also examined. Globular or cytoid body-like deposits of immunoglobulins, mainly IgM, were detected in forty-six of the active lesions, and in half the uninvolved skin biopsies. The deposition of fibrin in the papillary dermis and around follicular structures was seen only in the active lichen planus papules. The significance of these findings was assessed by comparison with the IF results obtained in 252 biopsies from various cutaneous disorders, stained by the same technique during the period of this study. Although the presence of immunoglobulin cytoid bodies and fibrin was found to be highly characteristic of lichen planus, these findings were not specifically diagnostic. Morphologically identical deposits were seen not infrequently in lupus erythematosus and in eczema. Active lesions of dermatitis herpetiformis, erythema multiforme and other rare dermatoses also showed these cytoid body-like immunoglobulin deposits.     

Lichen Planus in a Child Requiring Circumcision

Abstract: Lichen planus is a rare disorder in infants and children where it usually has the classical cutaneous pattern and only exceptionally involves the mucosa and skin appendages. A 9-year-old boy was referred to our department with a 4-month history of erythematous keratotic papules on the trunk and the upper and lower limbs. There were no signs of mucosal involvement. Subsequently white papules and striae, occasionally forming a lace like pattern, appeared on the penis and prepuce which quickly led to phimosis necessitating circumcision. Histologic examination of skin biopsy specimens and genital mucosa fragments confirmed the clinical diagnosis of lichen planus.     

带状疱疹继发Wolf′s同位反应2例

 报告2例带状疱疹继发Wolf′s同位反应。患者1,女,55岁,右侧腰腹部红斑、丘疹伴瘙痒半个月。半个月前,患者右侧腰腹部带状疱疹治愈后皮损愈合部位出现红斑、丘疹,伴瘙痒,结合皮损组织病理、病史及临床表现,诊断为带状疱疹继发湿疹Wolf′s同位反应。患者2,男,41岁,左侧腰背部红斑、丘疹伴瘙痒20 d。20 d前,患者左侧腰背部带状疱疹治愈后,原发皮损遗留色素沉着部位出现红斑、丘疹,结合皮损组织病理、病史及临床表现,最终诊断为带状疱疹继发扁平苔藓Wolf′s同位反应。     

Ulcerative lichen planus associated with Sjögren's syndrome

Ulcerative lichen planus is a rare variant of lichen planus that is characterized by ulcerations of the feet and toes that are accompanied by toenail loss. However, the nail, oral mucosa, genital mucosa and the scalp are also sometimes affected by ulcerative lichen planus. Several authors have drawn attention to the association of ulcerative lichen planus and autoimmune diseases. We report a patient who had ulcerative lichen planus, with ulcerative erythema on the soles and palms, nail dystrophy and oral lesions, as well as Sjögren's syndrome; she was successfully treated with etretinate.     

Lichen planus showing columnar epidermal necrosis

We describe a 9-year-old boy who presented with very itchy papules and plaques on both knees. Histologically, focal columnar epidermal necrosis was seen associated with features of classic lichen planus. A literature search using PubMed revealed that only two cases of transfusion-associated lichenoid graft-versus-host reaction showing columnar epidermal necrosis have been previously reported. Our case is the first of lichen planus showing columnar epidermal necrosis. In that lichenoid graft-versus-host reaction is a special form of lichen planus, it is possible to speculate that columnar epidermal necrosis may be a unique feature of lichen planus.     

Effectiveness of vitamin A acid in diseases of the mouth mucosa: lichen ruber planus, leukoplakias and geographic tongue]

52 patients, with different pattern of oral lichen planus, pre-malignant leukoplakia or geographic tongue, were treated with vitamin A acid. The systemic medication resulted in regression of discrete papules and leukoplakia-like appearance of oral lichen planus. Linear-hypertrophic pattern of the oral mucosa showed distinct involution only by topical administration of vitamin A acid. Also the patients suffering from pre-malignant leukoplakia or geographic tongue partly improved after a vitamin A acid therapy. Systemic side effects were noted after ignoring the tolerance limit (30 mg/day vitamin A acid/3 weeks). Inflammation and occasionally maceration appeared when local treatment was used over 3 weeks. Recurrence was observed in 11 patients.     

毛囊性扁平苔藓1例

患者男,60岁。双小腿散在分布红斑和丘疹伴瘙痒1年余。皮肤科情况:双小腿见散在分布绿豆至胡豆大淡紫红色扁平斑块和丘疹,上覆少许鳞屑,部分可见Wickham纹。皮损组织病理示:表皮显著角化过度,毛囊口扩张,毛囊角栓,毛囊漏斗部基底细胞液化变性、颗粒层增厚,其下方真皮层大量淋巴细胞和组织细胞浸润。诊断:毛囊性扁平苔藓。口服阿维A20mg,1次/d。现随访中。     

Coexistence of lichen planus and bullous pemphigoid (an immunofluorescence study of a "lichen pemphigoides") (author's transl)]

A 35 year old black man presented with a generalized eruption of lichen planus; subsequently tense blisters appeared within the lichenoid lesions and on clinically normal skin. Histopathological characteristics of lichen planus were present in the papules, and those of bullous pemphigoid were seen in the bullae taken from non-lichenoid skin. Direct immunofluorescence studies revealed immunological characteristics of lichen planus in skin and mucosal lesions of L. P. Bound IgG and beta1 C/beta1 A with tubular patterns were detected at the dermo-epidermal junction in all the skin fragments (clinically normal skin, bullous lesions lichenoid skin and mucous lesions). Indirect immunofluorescence studies showed at several intervals that the patient had circulating antibasement membrane zone antibodies (IgG; titres 1/50). This is the third published case in which immunofluorescence studies have established the "pemphigoid" nature of some bullous lichen planus. These findings are in favour of an immune disorder in lichen planus.