亲毛囊性蕈样肉芽肿一例

患者,男,28岁。全身瘙痒11年,头颈、躯干及双上肢红色丘疹、斑块伴嗜酸粒细胞增多5年,脱发2年。外周嗜酸粒细胞计数11 088/μL。组织病理示:毛囊周围中等量单一核细胞浸润,以不典型淋巴细胞为主,并见散在嗜酸粒细胞。免疫组化染色示浸润细胞主要是CD4+细胞。TCR基因重排示TCRδ、TCRγ均阳性。诊断:亲毛囊性蕈样肉芽肿。给予重组人干扰素α-2b肌注,阿维A、甲氨喋呤、泼尼松等口服,糖皮质激素软膏外用。治疗7周后皮损好转。     

亲毛囊性并肉芽肿性蕈样肉芽肿一例

患者男,90岁,头皮红斑伴痒20余年,加重4个月。患者20余年前无明显诱因头顶部发现半掌大红褐色斑片,伴小丘疹,略感瘙痒,逐渐扩大,伴鳞屑,就诊于多家医院,曾诊断为脂溢性皮炎、湿疹、环状肉芽肿等,予口服抗组胺药,外用他克莫司及糖皮质激素软膏等治疗,皮疹无缓解,面积逐渐扩大……     

儿童亲毛囊性蕈样肉芽肿一例

患者,女,12岁。5年前项部出现蚕豆大红色丘疹,偶有瘙痒。皮肤科查体：项部皮损干燥及轻度苔藓样变,可见一红褐色斑基础上密集分布肉色或淡红针帽大毛囊性丘疹,部分融合。右侧腰背部见一灰色干燥性皮损,表面见细糠状灰色或褐色鳞屑。结合临床表现、组织病理及皮肤镜检查,诊断为亲毛囊性蕈样肉芽肿。     

亲毛囊性蕈样肉芽肿误诊为毛发红糠疹1例

患者男,58岁。头面部、躯干及四肢红斑、鳞屑伴瘙痒1年。曾误诊为毛发红糠疹并给予治疗无效。3个月前因头部出现浸润性结节,遂再次就诊行皮肤活检、流式细胞及免疫组化检查,诊断为亲毛囊性蕈样肉芽肿。予以干扰素+维A酸胶囊+复方甘草酸苷胶囊+依巴斯汀片+曲氯乳膏方案治疗,治疗过程中行全身检查未见明显异常,目前病情基本控制,仍在随访中。     

类毛囊黏蛋白病的亲毛囊性蕈样肉芽肿1例

患者男,24岁。枕部右侧见出现大片毛发脱失19年。枕部右侧见成人手掌大不规则红斑,其上毛发脱失,界清,上覆少量不易刮除的细微鳞屑,皮温略高,周围可见少许残留毳毛。组织病理:毛囊及表皮可见炎症细胞浸润,以淋巴细胞为主。毛囊内可见Pautrier微脓肿。免疫组化染色:CD3(+),CD45Ro(+),白细胞共同抗原LCA(+),CD20(-),阿新兰染色(-)。诊断:类毛囊黏蛋白病的亲毛囊性蕈样肉芽肿。     

亲毛囊性蕈样肉芽肿四例分析

报道4例亲毛囊性蕈样肉芽肿。男3例,女1例,年龄32 ~ 52岁。3例以头面部及颈部受累为主,密集多发性暗红色不规则浸润性斑块、结节、肿块、毛囊性丘疹及痤疮样皮损,躯干、四肢表现为斑片、轻度浸润的斑块、毛囊性丘疹及痤疮样皮损。1例头面部未受累,全身密集毛囊性丘疹。组织病理显示真皮内、血管周围及毛囊周围大量淋巴样细胞为主的团块状浸润,部分细胞异形,浸润细胞移入毛囊上皮是他们共同而显著的特征,而亲表皮现象不明显。其中2例毛囊内充满黏蛋白,阿新蓝染色阳性。免疫组化显示浸润细胞主要为CD4阳性T细胞。对常规用于经典蕈样肉芽肿的治疗反应差,病情难以完全缓解,即使部分缓解后也极易复发。     

伴毛囊黏蛋白沉积的亲毛囊性蕈样肉芽肿一例

患者,男,37岁。全身丘疹、斑块、剧痒3年。3年前无明显诱因下于躯干、四肢等处出现丘疹、斑块,剧烈瘙痒,挤压后部分皮疹可见脓性分泌物。曾被诊断为＂毛囊炎、皮炎＂,先后口服异维A酸、糖皮质激素、雷公藤等治疗未好转。3年来皮疹逐渐增多。无发热、关节痛等不适,一般情况好。既往有痛风病史。查体：全身浅表淋巴结未触及肿大。系统检查未见明显异常。皮肤科情况：额面部潮红、浸润,以眉毛部位为显著并形成浸润性肿块。     

伴毛囊黏蛋白沉积的亲毛囊性蕈样肉芽肿

报告1例伴毛囊黏蛋白沉积的亲毛囊性蕈样肉芽肿。患者男,43岁。右侧眉弓、上眼睑斑块、丘疹6个月,眉毛脱落4个月。皮损组织病理:真皮内及毛囊、附属器周围见大量淋巴样细胞团块状浸润,部分细胞异形,部分毛囊上皮可见不典型淋巴样细胞移入,毛囊内充满黏蛋白;阿辛蓝染色阳性。免疫组化显示浸润细胞主要是CD4~+T细胞。T细胞受体基因重排结果为阴性。诊断:伴毛囊黏蛋白沉积的亲毛囊性蕈样肉芽肿。     

毛囊性蕈样肉芽肿1例

毛囊性蕈样肉芽肿是一种少见的皮肤T细胞淋巴瘤,属蕈样肉芽肿的特殊类型,国内外报道较少1.现将我们所见1例报道如下.     

以弥漫性秃发为首发表现的亲毛囊性蕈样肉芽肿一例

亲毛囊性蕈样肉芽肿属于蕈样肉芽肿的一种亚型，侵袭性较强，预后差，早期诊断尤为重要。本文报道一例免疫组化联合TCR基因重排确诊的以弥漫性秃发为首发表现亲毛囊性蕈样肉芽肿一例。     

Pseudotumorous folliculotropic mycosis fungoides

Fungating nodules and infiltrated plaques are usually equated with advanced tumor stage mycosis fungoides. We report an 85-year-old man who presented in this way but multiple skin biopsies revealed that the bulk of his nodules were due to marked follicular hyperplasia as a result of folliculotropic mycosis fungoides. This clinical presentation may be best described as a pseudotumorous form of mycosis fungoides dominated by follicular epithelial hyperplasia rather than lymphocytic proliferation characteristic of true tumor stage disease. Similar presentations have been described as a verrucous and hyperplastic variant of mycosis fungoides due to the presence of prominent epidermal hyperplasia.     

Juvenile folliculotropic and ichthyosiform mycosis fungoides

Ichthyosiform mycosis fungoides (MF) is a recently recognized clinical variant of MF, which appears as dry scaling patches and plaques, or as a generalized eruption. Acquired ichthyosis is well recognized as a paraneoplastic cutaneous presentation of malignancy, especially in lymphoproliferative disorders. In contrast, the ichthyosiform eruption in ichthyotic MF is attributable to infiltration of the skin by tumour cells. We report the case of a 15-year-old boy who presented with a 5-year history of enlarging pruritic plaques on the forehead and back, patchy alopecia and generalized ichthyosis. Histology of the forehead and back showed a dense, lymphocytic, folliculocentric and perivascular infiltrate of predominantly CD4-positive T cells consistent with folliculotropic MF. Histological examination of biopsies from ichthyotic skin found similar features. Our patient had a histological diagnosis at the age of 15 years, making him the youngest reported patient with either folliculotropic MF or ichthyotic MF.     

毛囊角化病1例

临床资料患者,女,22岁。主因面部、胸前皮疹4年,加重1月,于2008年10月到我科就诊。4年前患者面部和胸前出现片状淡红色丘疹,伴有轻度瘙痒,曾于外院按"脂溢性皮炎"诊治,无好转,皮疹夏     

不伴有毛囊黏蛋白沉积的向毛囊性蕈样肉芽肿1例国内首报

报告1例不伴有毛囊黏蛋白沉积的向毛囊性蕈样肉芽肿.患者女,53岁.全身泛发红色毛囊性丘疹伴瘙痒1年.皮肤科检查见躯干、四肢泛发针头大红色毛囊性丘疹,密集分布,互不融合,外观酷似突起的鸡皮疙瘩,触之粗糙.皮损不累及头面部、手掌和足部.皮损组织病理检查:毛囊周围可见以淋巴细胞为主的细胞浸润,部分细胞侵入毛囊上皮和表皮,细胞深染.核周有空晕,异形不明显.免疫组化染色结果证实浸润的淋巴细胞主要是T淋巴细胞.皮损T细胞受体(TcR)基因重排阳性.诊断:不伴有毛囊黏蛋白沉积的向毛囊性蕈样肉芽肿.     

Foreign-body-associated granulomatous slack skin in folliculotropic mycosis fungoides of childhood

Presented in part at the XXVIII Symposium of the International Society of Dermatopathology, Paris, November 14–17, 2007.
A 13-year-old boy developed a bulky mass close to the right axillary region and an infiltrated plaque on the abdominal skin. Two years earlier, the diagnosis of follicular mycosis fungoides has been established. Biopsies of both areas revealed typical features of granulomatous slack skin (GSS). Within some of the giant cells, doubly refractile material of unknown origin was found. It may be speculated that in the reported case of follicular mycosis fungoides in childhood, GSS developed as a specific reaction pattern of the disease because of foreign bodies.     

Two cases of aggressive nontumoral folliculotropic mycosis fungoides with visceral involvement

Mycosis fungoides (MF) is the most common type of primary cutaneous T‐cell lymphoma (CTCL), and folliculotropic MF (FMF) is one clinical variant of classic MF. MF generally has a good prognosis with an indolent clinical course, but for FMF greater therapeutic resistance is suggested. Visceral involvement is very rare in these two clinical forms. We report two exceptional cases of FMF with pulmonary and hepatic involvement. Five years after their initial diagnoses, patient 1 presented with a pulmonary localization of his FMF, and patient 2 with liver involvement, without lymph node or T‐cell clones in the blood. These two patients had FMF corresponding to stage T2N0M1B0. These two cases highlight the aggressiveness of this rare variant of MF. They suggest that the T lymphocytes found in the folliculotropic form of CTCL could be characterized by greater visceral tropism. They raise the question of the molecular and functional characteristics of these T lymphocytes, and the possibility of a common target in the hair follicles and certain organs. Studies have shown that chemokine receptors are likely to be involved in the skin tropism that characterizes CTCL. These two cases show the aggressiveness of FMF and point to the interest in comparing the molecular characteristics of T lymphocytes in the folliculotropic and nonfolliculotropic forms of CTCL.