肉芽肿性唇炎1例

患者男，42岁因上唇肿胀、肥厚2年，于2002年11月来笔者所在医院就诊。患者于2年前无明显诱因上唇肿胀，无自觉症状，在多家市级医院诊断为“血管性水肿”，用抗抗组胺药治疗稍有减轻，但未完全消退。上唇逐渐肥厚，进展缓慢，无破溃、糜烂，无鳞屑。仍按“血管性水肿”治疗，在用抗组胺药物治疗无效后，改用泼尼松40～60mg/d治疗,能暂时缓解，停药则复发。     

肉芽肿性唇炎

患者男,45岁。 主诉：下唇肿胀1年。 现病史：患者自2002年12月起无明显原因出现下唇左侧肿胀,无痒痛,偶有麻木感,未引起重视。肿胀持续不退．并逐渐向下唇右侧发展。曾在当地医院多次就诊,诊断为“血管神经性水肿”、“唇炎”等,口服多种抗组胺药物及抗生素,均未见疗效。自发病以来口唇无糜烂渗出,面部皮肤未出现异常。     

肉芽肿性唇炎

报告1例肉芽肿性唇炎。患者女,74岁。下唇部左侧及下颌部红肿3年,无自觉症状。皮肤科检查:下唇部左侧及下颌部可见水肿性紫红色斑块,触之有浸润感。皮损组织病理检查:表皮轻度萎缩,表皮突消失,真皮内结节状炎性细胞浸润(组织细胞、淋巴细胞及浆细胞),可见上皮样细胞肉芽肿,血管数目增多,管壁增厚,伴有内皮细胞肿胀。诊断:肉芽肿性唇炎。治疗:复方倍他米松局部注射,每月1次,共2次,皮损明显好转。     

肉芽肿性唇炎1例

患者女,52岁.因右上唇红肿4年,加重2年,于2007年1月来我科就诊.患者4年前无明显诱因右上唇出现红肿,局部有灼热感,无瘙痒、疼痛,自觉口渴,饮水后症状不能缓解,红肿不能自行消退,每于感冒后自觉症状加重,未予治疗.数月后红肿延及右侧面颊,红肿时重时轻,但不能完全消退.2年前,左面颊也出现红肿,但较右侧轻,在当地治疗效果不佳.既往体健,否认有局部外伤史.家族中无类似疾病患者.     

中西医结合治愈肉芽肿性唇炎

中西医结合治愈肉芽肿性唇炎张（济南市中心医院皮肤科２５００１３）张玮（山东省中医药大学附属医院２５００１１）肉芽肿性唇炎（ＣｈｅｉｌｉｔｉｓＧｒａｎｕｌｏｍａｔｏｓａ简称ＣＧ），其主要临床特征是反复发作的唇及面部肿胀与肥厚，病史较长，治愈较困难，易...     

肉芽肿性唇炎1例

肉芽肿性唇炎是一种以唇部反复肥厚肿胀为主要特征的少见疾病,其发病机制目前尚不明确,治疗尚无特殊方法。本文报道1例肉芽肿性唇炎患者,口服复方甘草酸苷片、海棠合剂,外用他克莫司治疗有效。     

肉芽肿性唇炎误诊为扁平苔藓1例

患者女,38 岁.因下唇红肿及结厚痂2 年余,于2010 年4月12 日到同济医院皮肤科就诊.患者无明显原因自感嘴唇干燥、皲裂、脱屑等约10 年,并于2 年前出现下唇肿胀,无明显灼痛及瘙痒等不适,其后表面开始结痂,且红肿,痂皮不能自行消退,但痂皮能自行剥离,剥除后仍会再次结痂,无发热、口腔溃疡及关节痛等不适.于去年在本市某院做组织病理检查提示扁平苔藓并给予金霉素甘油、莫匹罗星软膏(百多邦)及维生素B12等治疗后皮损稍显好转,后又到外地某院按扁平苔藓给予羟氯喹及调节免疫等治疗,无明显效果,皮损仍时轻时重.     

肉芽肿性唇炎1例

患者女,65岁,农民.下唇及下颌部皮肤红肿4个月,于2008年5月7日来我院首次就诊.4个月前无明显诱因下颌部皮肤弥漫性红肿,后逐渐扩展至整个下唇部,无明显自觉症状.红肿时重时轻,但不能完全消退,发病以来未予治疗.既往有高血压病史5年,无糖尿病史、长期服药史及过敏史.家族及个人史无特殊.系统检查：血压150/75 mmHg,其余未见明显异常.皮肤科检查：下颌左侧皮肤明显肿胀,呈暗红色,触之韧,边界清,下唇轻度红肿.     

自制生肌膏治疗剥脱性唇炎36例临床观察

目的：观察自制生肌膏治疗剥脱性唇炎的临床疗效。方法：对60例剥脱性唇炎患者随机分为治疗组36例和对照组18例，治疗组用自制生肌膏，对照组用丁酸氢化可的松软膏，均外用三周后进行临床疗效观察。结果：治疗组总有效率为67．00％；对照组总有效率为45．00％，两组差异无统计学意义（P〉0．05）。结论：生肌膏治疗剥脱性唇炎安全有效。     

浆细胞性唇炎1例

报告1例浆细胞性唇炎。患者女,78岁,右上唇持续性红色斑块2年,斑块质地柔软,界限清楚,表面轻度糜烂。皮肤组织病理显示粘膜固有层多量浆细胞浸润。诊断为浆细胞性唇炎。     

Idiopathic granulomatous vulvitis

A 20-year-old woman initially presented with clinical evidence of an acute vulval inflammatory disorder incorrectly diagnosed as a Bartholin's abscess. Prolonged healing associated with infection followed attempts to incise and biopsy the area. Over a decade the condition has followed a chronic course with exacerbations and remissions and the vulva has become progressively more swollen and distorted. Lymphangiomas have developed. Histology showed non-necrotizing granulomas. Investigations for Crohn's disease and sarcoidosis were negative. Prednisone resulted in improvement during acute inflammatory episodes.     

Therapy of noninfectious granulomatous skin diseases with fumaric acid esters

BACKGROUND: Noninfectious granulomatous skin diseases are inflammatory disorders of unknown aetiology which are often recalcitrant to common anti-inflammatory treatment regimens. Recently, in several case reports, fumaric acid esters (FAE) have proved beneficial in granulomatous skin diseases, but studies on a larger collection of consecutive patients have not yet been performed. OBJECTIVES: To investigate the therapeutic efficacy of FAE for the treatment of granulomatous skin diseases. PATIENTS AND METHODS: The therapeutic efficacy and side-effects of FAE were analysed retrospectively in 32 patients with disseminated granuloma annulare (n = 13), annular elastolytic giant cell granuloma (n = 3), sarcoidosis (n = 11), necrobiosis lipoidica (n = 4), or granulomatous cheilitis (n = 1). RESULTS: Three patients discontinued treatment within 4 weeks because of side-effects. Of the remaining 29 patients, 18 patients responded to treatment with FAE. Marked improvement or complete clearance was seen in seven patients. We observed a slight to moderate improvement in 11 patients, and 11 patients did not respond. In patients showing a complete remission, the maximum effect was observed after 8.5 months (SD +/-6 months, range 3-20 months). In two patients with systemic sarcoidosis, the pulmonary changes improved in parallel with the skin. Side-effects were usually mild and resolved spontaneously upon dose reduction or discontinuation of the therapy. CONCLUSIONS: The data presented here indicate that FAE may be considered for the treatment of recalcitrant granulomatous skin disease.     

Possible role of Mycobacterium tuberculosis complex in Melkersson-Rosenthal syndrome demonstrated with Gen-Probe amplified Mycobacterium tuberculosis direct test

Melkersson-Rosenthal (MRS) syndrome is characterized by a classical triad of recurrent or persistent orofacial swelling, peripheral facial nerve paralysis and lingua plicata. Granulomatous cheilitis (GC) is regarded as a monosymptomatic form of MRS. The exact aetiologies of MRS and GC are unknown. In this study we investigated the possible role of mycobacteria in these two conditions. A ribosomal RNA amplification-based Gen-Probe amplified Mycobacterium tuberculosis direct test was used to investigate the presence of M. tuberculosis complex in paraffin-embedded skin biopsy specimens from five patients with MRS and one patient with GC. Three of the six specimens were shown to be positive using this system; one of the positive specimens also showed positive Ziehl-Neelsen staining. These results suggest a possible mycobacterial aetiology for MRS and GC.     

8例汗孔瘤临床及病理分析

目的:总结汗孔瘤的临床及病理特征。方法:回顾性分析8例汗孔瘤患者的临床和病理资料。结果:8例患者中,男3例,女5例。6例40岁后发病。4例皮损发生于掌跖。临床诊断为化脓性肉芽肿2例、血管瘤1例、皮肤纤维瘤2例、寻常疣1例,仅2例典型皮损疑诊汗孔瘤。8例患者病理改变均符合汗孔瘤。结论:汗孔瘤皮损临床上与多种增生性疾病相似,确诊需病理检查。     

Sarcoidosis with cutaneous granulomatous vasculitis

Ulceration of non‐caseating granulomas is a rare cutaneous presentation of sarcoidosis. Granulomatous vasculitis is classically associated with Wegener's granulomatosis, lymphomatoid granulomatosis or Churg–Strauss syndrome. It is also commonly noted in pulmonary sarcoidosis, but has seldom been reported in cutaneous sarcoidosis, particularly the ulcerative variant. We present a rare case of sarcoidosis with multiple purpuric leg ulcers showing a granulomatous vasculitis histologically.     

反应性肉芽肿性皮炎的分类及临床研究进展

反应性肉芽肿性皮炎包括栅栏状中性粒细胞性肉芽肿性皮炎、间质性肉芽肿性皮炎及间质性肉芽肿性药物反应三类疾病.其病因及发病机制尚不明确,临床及组织病理表现多样,常伴有系统性疾病如类风湿关节炎和系统性红斑狼疮.本文综述了这三类疾病的发病机制、临床和病理特点、诊断和治疗等.     

肉芽肿性蕈样肉芽肿一例

患者男,42岁.因全身皮肤红斑鳞屑10年,结节、肿瘤8年于2004年8月就诊.10年前患者无明显诱因背部出现一鱼鳞病样斑片,无自觉症状.1个月后,胸背部皮肤出现片状淡红斑,微痒,并逐渐扩展至头面部、颈、四肢,呈弥漫性,红斑上有细小糠状鳞屑.在当地医院多次按湿疹治疗无明显好转.     

Interstitial granulomatous dermatitis and granulomatous arteritis in the setting of PD-1 inhibitor therapy for metastatic melanoma

Checkpoint inhibition has become an important target in the management of malignant melanoma. As anti-CTLA4 inhibitors and anti-PD1 antibodies are increasingly utilized, reports of immune-related adverse events (IRAEs) are becoming more frequent. Common noted cutaneous IRAEs are morbilliform, lichenoid, bullous, granulomatous, psoriasiform, and eczematous eruptions. We report a case of interstitial granulomatous dermatitis and granulomatous arteritis in the setting of nivolumab (anti-PD1) monotherapy for metastatic melanoma. There are many different causes for granulomatous vasculitis, such as herpes virus infection, lymphoproliferative disorders, systemic vasculitis, and inflammatory bowel disease. This report adds to the growing literature on granulomatous IRAEs due to checkpoint inhibition.     

Annular lesions of cutaneous sarcoidosis with granulomatous vasculitis

Sarcoidosis is known to be involved in diseases with vasculitis as sarcoid vasculitis. However, vasculitis in cutaneous sarcoidal lesions is extremely rare. Here we describe a case of sarcoidosis with multiple annular skin lesions with granulomatous vasculitis. A 62‐year‐old female was diagnosed with sarcoidosis by chest‐abdominal computed tomographic examination and laboratory tests. The skin lesions had appeared on her lower limbs 2 years before. Physical examination showed multiple infiltrated annular eruptions on the lower extremities. A skin biopsy of an area of erythema showed multiple non‐caseating epithelioid cell granulomas in the dermis and subcutaneous fat and granulomatous vasculitis with fibrinoid degeneration in the subcutaneous fat. There are two types of vasculitis in sarcoidosis: leukocytoclastic and granulomatous vasculitis. Ulcers and livedo were more common in granulomatous vasculitis than in leukocytoclastic vasculitis. The present case had unique annular skin lesions of sarcoidosis with granulomatous vasculitis.