线状皮肤型红斑狼疮六例

目的 探讨线状皮肤型红斑狼疮(LCLE)临床和组织病理学特点.方法 回顾分析6例LCLE的临床和病理学特点.结果 LCLE多单侧发病,表现为带状或线状分布的暗红斑,伴毛细血管增生扩张,部分黏着性鳞屑.组织病理学诊断依据为真皮浅、深丛细血管周围及毛囊、皮脂腺、汗腺周围有致密团块状淋巴细胞浸润,部分病例可见表皮角化不全,毛囊角栓,基底细胞液化变性,类似盘状红斑狼疮组织像.治疗以氯喹为首选,对于皮疹范围较广泛,且组织病理改变见淋巴细胞浸润达真皮深部甚至皮下脂肪小叶处的患者,给予小剂量糖皮质激素治疗疗效明显.结论 LCLE诊断需要结合临床和组织病理.     

线状皮肤型红斑狼疮六例

目的 探讨线状皮肤型红斑狼疮（LCLE）临床和组织病理学特点。方法 回顾分析6例LCLE的临床和病理学特点。结果 LCLE多单侧发病,表现为带状或线状分布的暗红斑,伴毛细血管增生扩张,部分黏着性鳞屑。组织病理学诊断依据为真皮浅、深丛细血管周围及毛囊、皮脂腺、汗腺周围有致密团块状淋巴细胞浸润,部分病例可见表皮角化不全,毛囊角栓,基底细胞液化变性,类似盘状红斑狼疮组织像。治疗以氯喹为首选,对于皮疹范围较广泛,且组织病理改变见淋巴细胞浸润达真皮深部甚至皮下脂肪小叶处的患者,给予小剂量糖皮质激素治疗疗效明显。结论 LCLE诊断需要结合临床和组织病理。     

线状皮肤型红斑狼疮1例

患者男,68岁。鼻背部丘疹、斑块1个月。皮肤科情况:鼻背部可见6.0cm×0.5cm大小线状分布的融合性褐色扁平斑块,沿Blaschko线分布,表面轻度萎缩,境界清楚,质软,压之不退色,压痛阴性。皮肤组织病理显示:角化过度,表皮萎缩,见毛囊角栓,表皮及毛囊基底层空泡变性,色素失禁,真皮浅层至中层血管、毛囊周围及间质内见较密集淋巴细胞浸润。诊断:线状皮肤型红斑狼疮。     

以眼睑和头皮红斑为表现的早期皮肤型红斑狼疮一例

患者,女,29岁。左眼睑红斑3个月,发现头皮脱发区1天。头皮组织病理：表皮轻度角化过度,基底细胞灶性液化变性,真皮浅层血管周围少许单一核细胞浸润,真皮内毛囊数量明显减少,真皮深层毛囊及附属器周围较多淋巴细胞浸润。免疫荧光：表皮基底膜C3、IgM、IgA弱阳性带状沉积,IgG阴性。阿新蓝染色:胶原间黏蛋白沉积。诊断为皮肤红斑狼疮。给予硫酸羟氯喹片口服、他克莫司软膏和卤米松软膏外用治疗,红斑消退。     

线状盘状红斑狼疮

报告1例发生于额部的线状盘状红斑狼疮.患儿女,15 岁.左额部带状红斑伴瘙痒3 年.皮肤科检查:左侧发际、额部、左上眼睑有一纵行走向的带状红斑,呈S 形分布,表面可见萎缩及毛细血管扩张.组织病理检查:毛囊角栓形成、基底层液化变性、基膜带增宽、真皮血管和附属器周围淋巴细胞呈片状或团块状浸润,符合盘状红斑狼疮组织病理学改变.     

毛发扁平苔藓特殊皮肤镜表现一例

患者,女,56岁,脱发4个月.本例患者除皮肤镜下毛发扁平苔藓典型特点毛囊周围的管状鳞屑外,还可以看到较多猪尾状卷曲发、内生发等.病理检查:表皮萎缩、变薄、基底细胞液化变性,真皮浅层淋巴细胞浸润,毛囊周围可见淋巴细胞浸润,毛囊周围纤维化.诊断:毛发扁平苔藓.     

肿胀性红斑狼疮的研究进展

肿胀性红斑狼疮为皮肤型红斑狼疮的亚型之一,其临床特征为紫红色斑,单个或多发斑块,表面光滑,边界清楚,不形成瘢痕,无糜烂、萎缩、鳞屑、毛囊角栓等表皮的改变,且具有显著光敏性,好发于日光暴露部位.组织病理学特点为血管及附属器周围淋巴细胞浸润,真皮网状层黏蛋白沉积,无明显表皮受累,直接免疫荧光检测为阴性.氯喹和羟氯喹治疗有效.     

线状皮肤型红斑狼疮4例

患者女3例,男1例,4例皮疹表现均为沿单侧头面部Blaschko线走行的线状及条带状红斑或斑块。抗核抗体1例阳性、3例阴性,ENA谱均阴性。病理类型均为盘状红斑狼疮,表现为角化过度,角栓形成,表皮不规则增生与变薄,局灶性基底细胞液化变性,真皮血管附属器周围淋巴细胞浸润。硫酸羟氯喹口服或他克莫司外用治疗效果明显。该病临床少见,诊断需结合临床特点及组织病理学。     

肿胀性红斑狼疮误诊为过敏性皮炎

报告1例肿胀性红斑狼疮。患者女,24岁。面部反复出现红斑、斑块1年半,加重10 d。皮肤科检查:双侧面颊红斑、斑块,无鳞屑、瘢痕及萎缩。皮损组织病理检查:表皮角化过度,基底层及毛囊上皮细胞液化变性,血管及毛囊周围淋巴细胞及组织细胞浸润。阿辛蓝染色示真皮网状层黏蛋白沉积。根据其临床、皮损组织病理及免疫病理表现,诊断为肿胀性红斑狼疮。     

前额纤维化性脱发1例

患者女,40岁,前额及两侧颞部毛发脱落8年。皮肤科情况:前额及两侧颞部发际线带状后移,眉毛脱落,部分毛囊口消失。皮损组织病理示:表皮部分基底细胞空泡变性,真皮浅层小血管周围散在淋巴细胞浸润,真皮内可见个别毛囊结构,周围密集淋巴细胞浸润,纤维组织增生。诊断:前额纤维化性脱发。患者拒绝治疗。     

Tumid lupus erythematosus.

BACKGROUND: Tumid lupus erythematosus (TLE) is a subtype of discoid lupus erythematosus (DLE) whose clinical characteristics rarely have been described in the literature. OBJECTIVE: To describe the clinical, histopathologic, and other laboratory findings in tumid lupus erythematosus. METHODS: Clinical and laboratory findings were reviewed in four patients who had been diagnosed with tumid lupus erythematosus by conventional microscopy. The diagnoses were characterized by a superficial and deep perivascular infiltrate of lymphocytes and deposits of mucin in foci in the reticular dermis. RESULTS: All four patients were young women. Ages ranged from 16 to 39 years (mean 21 years). The lesions consisted of numerous erythematous papules and plaques, some with annular configuration situated in the face and neck, trunk, and upper extremities. All four patients had concurrent lesions of classic DLE, three of them had systemic lupus erythematosus (SLE). Direct immunofluorescence test results were negative in nonexposed lesional skin of two of the patients. CONCLUSION: The clinical findings of concurrent lesions of TLE and classic DLE in the same patient, the presence of lesions of TLE in patients with SLE, and the histologic findings demonstrate that TLE is a distinct manifestation of DLE, and as such, a cutaneous expression of SLE.     

Fas抗原及Fas配体在红斑狼疮患者皮损中的表达

目的 研究Ｆａｓ抗原及Ｆａｓ配体（Ｆａｓ－Ｌ）在红斑狼疮皮损中的表达情况。方法 应用免疫组化技术检测２５例系统性红斑狼疮（ＳＬＥ）及１４例盘状红斑狼疮（ＤＬＥ）不同病程的皮损中Ｆａｓ抗原及Ｆａｓ－Ｌ的表达。结果 ＳＬＥ及ＤＬＥ早期皮损朊细胞Ｆａｓ抗原表达强度显著高于正常皮肤（Ｐ〈０．０１）,与病程呈负相关（Ｐ〈０．０５）,且真皮中单一核细胞亦有Ｆａｓ抗原表达;红斑狼疮患者皮损及正常皮肤的角朊细胞均     

Linear Cutaneous Lupus Erythematosus in the Lines of Blaschko

The lines of Blaschko describe distribution patterns which may represent embryologic developmental pathways. This distribution may occasionally be followed by some congenital and acquired skin disorders. We describe a child with linear cutaneous lupus erythematosus (LCLE) following Blaschko lines on the face.     

线状皮肤型红斑狼疮

目的:分析线状皮肤型红斑狼疮的临床表现、组织病理及免疫组化组织病理特点.方法:采用回顾性分析方法对7例线状皮肤型红斑狼绝患者的临床表现、组织病理改变、免疫荧光及实验窀检查资料进行分析.结果:7例患者中男2例,女5例;平均年龄23岁(4～40岁);平均发病年龄19.43岁(3～37岁),其中2例发病年龄<6岁.皮损部位:1例位于左下肢,其余6例均位于头面部.皮损均呈线状分布,其走向与Blasehko线一致;所有患者均无系统受累的证据.结合组织病理和免疫荧光检查,6例诊断为线状盘状红斑狼疮,1例为线状深在性红斑狼疮.结论:线状皮肤型红斑狼疮是红斑狼疮的罕见变异型,不引起系统受累.临床诊断有一定困难,需借助于组织病理和免疫荧光检查.     

亚急性皮肤红斑狼疮1例

患者女,41岁。颜面红斑伴光敏感16月。实验室检查:ANA阳性、抗SS-A(Ro)、抗SS-B(La)均阳性;组织病理示:表皮萎缩变薄,基底细胞点状液化变性,真皮浅层及附属器周围淋巴细胞浸润。诊断:亚急性皮肤红斑狼疮(环状红斑型)。     

Verrucous lesions in patients with discoid lupus erythematosus

Seven cases of classical discoid lupus erythematosus of the face associated with hyperkeratotic, papulo-nodular lesions on the arms and hands were studied. Clinically the hyperkeratotic lesions resembled keratoacanthomas or hypertrophic lichen planus. The clinical course was marked by chronicity, an absence regression of the lesions, and resistance to treatment. Histopathologically, a lichenoid cellular reaction seemed to play a key role in the development of the hypertrophic lesions which resembled either keratoacanthomoas or hypertrophic lichen planus. Elastic fibres were prominent in the upper dermis, the lower levels of the epidermis and in the hyperkeratotic horny layer. Immunofluorescence of the papulo-nodular lesions demonstrated the deposition of IgG and IgM in a globular pattern at the dermal-epidermal junction. Discontinuous deposition of these antibodies was also seen at the basement membrane zone. On the basis of the immunofluorescence, histopathological and clinical studies, we suggest that the verrucous, hyperkeratotic lesions on the upper extremities represent an unusual, but distinct, form of discoid lupus erythematosus.     

Multiple cutaneous fibrous histiocytomas in association with systemic lupus erythematosus

Cutaneous fibrous histiocytomas are usually regarded as superficial lesions and commonly known as dermatofibromas; however, unusual cases histologically showing fibrohistiocytic proliferation extending into the deeper dermis or subcutaneous tissues are occasionally experienced. Some authors propose this type as benign fibrous histiocytoma of the skin, distinct from dermatofibroma. We describe herein a case of systemic lupus erythematosus (SLE) who developed multiple nodules on the face, trunk and extremities. The nodule on the forehead did not present a typical clinical appearance of dermatofibroma, and histopathological examination showed fibrohistiocytic proliferation with a storiform pattern extending into the deep dermis and subcutaneous tissues. By contrast, histology of the nodule on the abdomen showed fibrohistiocytic proliferation confined to the dermis and compatible with dermatofibroma. Although multiple dermatofibromas are occasionally seen in patients with SLE, benign fibrous histiocytoma of the skin showing deeper invasion than dermatofibroma is rarely associated with SLE.