痒疹样营养不良型大疱性表皮松解症1例

患者女,45岁。臀部、小腿、足背丘疹、斑块、水疱伴瘙痒4年。曾诊断为"湿疹",糖皮质激素治疗无效。臀部、双小腿胫前、足背对称性分布暗红色丘疹及斑块,部分斑块上可见水疱,Nikolsky征阴性,局部见瘢痕及粟丘疹,可见甲营养不良。皮损组织病理示:表皮下水疱形成,疱内未见嗜酸性粒细胞,直接免疫荧光结果 Ig G,Ig A,Ig M,C3均阴性。诊断:痒疹样营养不良型大疱性表皮松解症。     

非糖尿病性类脂质渐进性坏死2例并文献复习

例1男,57岁,双小腿胫前散在暗红色环状红斑10年。例2男,43岁,双小腿胫前弥漫性暗红斑5年。空腹血糖正常。胫前皮损组织病理示:表皮轻度萎缩,真皮深层可见肉芽肿性血管炎性改变,在血管壁及其周围有组织细胞、多核巨细胞浸润。诊断:非糖尿病性类脂质渐进性坏死。     

父子同患斑驳病1例报告

正1临床资料患儿男,4个月。因前额、腹部、双小腿胫前白斑3月来我科门诊就诊。患儿出生后20余天后于前额、腹部、双小腿胫前皮肤出现不规则白斑,伴有前额部白发,白斑范围不随患儿增长变大,但白斑中央渐出现小片岛状色素过度沉着区。查体:一般情况可,生长发育无异常。专科查体:额部中央偏左     

甲状腺乳头状癌合并嗜酸性蜂窝织炎1例

患者女,14岁。甲状腺乳头状癌次全切术后7周,双小腿红肿2周。体检:双下肢可见大片水肿性红斑,界限不清,触诊有浸润感,无压痛,皮温高。外周血嗜酸性粒细胞计数升高。皮损组织病理示:表皮灶性海绵水肿,真皮浅层水肿,真皮全层可见血管周围及胶原束间多数嗜酸性粒细胞浸润,血管周围见中等密度组织细胞、淋巴细胞浸润。诊断:嗜酸性蜂窝织炎。     

嗜酸细胞增多综合征1例

患者男,37岁。1995年5月入院。2月前双下肢胫前出现米粒大红色丘疹伴瘙痒,并逐渐波及大腿及上肢,以双下肢伸侧较著,瘙痒加剧。2月后出现双足背红肿微痒,上有小水疱。体检:系统检查未发现异常。皮肤科情况:四肢有散在米粒至黄豆大红色坚实丘疹,以双小腿胫前较著。丘疹表面无坏死及溃烂,有抓痕。基底肤色正常。双足背红肿,压之凹陷,局部不热,其上有小水疱,尼氏征(-)。左耳后有2cm长的条形硬结,无压痛。实验室检查:Hb133g/L,WBC7.3×109/L,N0.5,L0.22,E0.28,嗜酸细胞计数2.0×106/L;骨髓象:嗜酸粒细胞中幼0.005,晚幼0.03,分叶0.105。胸片示…     

嗜酸性蜂窝织炎一例

患者男,29岁,双小腿反复红斑、丘疹伴肿胀8个月,于2002年11月入院。8个月前患者双小腿出现米粒大红色丘疹,瘙痒伴肿胀,按湿疹治疗后缓解,但仍时有反复,2个月前左前臂桡侧出现黄豆大红斑,瘙痒,皮损渐扩大、变硬,未予治疗。入院前双踝部出现肿胀,右胫前大片水肿性红斑,考虑为丹毒,给予青霉素800万U每日静脉滴注,共12d,未见明显疗效,且在红斑上出现数个米粒大到指甲大水疱,而收住院治疗。否认病前有虫咬史,疾病发作与药物无明确关联,病中无发热。儿时双小腿有烫伤史,家族史无特殊。体检:各系统检查无异常。皮肤科体征:右胫前可见一15cm×8cm大…     

穴位封闭疗法治愈胫前粘液性水肿1例

穴位封闭疗法治愈胫前粘液性水肿１例桂林市中西医结合医院皮肤科邓翠荣患者女性，５７岁，因双小腿下部斑块伴破溃、流脓半年就诊。既往有甲亢病史，检查：双小腿下１／３部位皮肤呈环状肿胀，有大小不等、形状不规则之斑块，压之无凹陷，局部破溃，诊断：胫前粘液性水肿...     

嗜酸性筋膜炎并发间质性肺炎1例

嗜酸性筋膜炎是以炎症及硬化性改变,主要累及筋膜为特点,很少累及内脏。近来我科收治1例嗜酸性筋膜炎并发间质性肺炎,现报告如下。患者,女,49岁。1997年10月起双前臂及小腿肿胀、稍酸痛,但能坚持劳动。继而渐感前臂、小腿发硬,当地医院疑为“硬皮病”给中药治疗,症状无改善。于     

复发性皮肤坏死性嗜酸性血管炎1例并文献复习

报道1例复发性皮肤坏死性嗜酸性血管炎并对相关文献进行复习。患者，女，64岁，因双下肢痛性皮疹12天就诊。偶有干咳，无哮喘病史。皮肤科查体：双下肢散在紫红色斑片、斑块，胫前数个结节、血疱样损害；右前臂有少量类似损害。外周血嗜酸性粒细胞计数增多。胸部X线提示双肺渗出性改变。皮损组织病理符合皮肤坏死性嗜酸性血管炎。口服强的松45mg/天治疗1周后临床症状明显好转，激素减量过程中曾有复发。     

痒疹样营养不良型大疱性表皮松解症1例

报告1例痒疹样营养不良型大疱性表皮松解症.患者女,41岁,双小腿丘疹、结节伴瘙痒2年余.皮肤科检查:双小腿伸侧可见密集米粒至花生大小丘疹、结节,周边有色素沉着,部分表面抓痕、糜烂.皮损组织病理:表皮角化过度,真表皮交界处可见裂隙,真皮浅层散在角囊肿,浅层血管周围可见散在淋巴浆细胞及个别嗜酸性粒细胞浸润.免疫荧光:C3(...     

Bullous morphea profunda

A deep sclerotic process developed on the shins of a 58-year-old man, and eosinophilic fasciitis or morphea profunda was suspected clinically. Bullae later arose on the plaques, and histologic examination of a skin biopsy specimen revealed sclerosis and inflammation of the deep dermis, panniculus, and fascia, with subepidermal edema causing formation of bullae. No lymphatic obstruction or vasculitis was seen. Two plaques of typical morphea on the penis were noticed 10 months later. The patient had no peripheral or tissue eosinophilia, hypergammaglobulinemia, hematologic abnormality, or history of exertion before the onset of the disease. The sclerotic process involved more than the fascia. In describing this deeper variant of morphea, the term "morphea profunda" appears to be more appropriate than "eosinophilic fasciitis."     

Giant pilomatricoma

A 52-year-old man was examined for an ulcerated, rapidly growing reddish nodule. It was 5.5 cm high with an 11 x 6-cm base and located on the left clavicle. The lesion had been present for approximately 7 years, and the patient complained occasional burning and pain. Clinical differential diagnoses included cutaneous lymphoma, sarcoma, squamous cell carcinoma, and cutaneous metastasis. Histopathologic examination revealed a well-circumscribed tumor involving the whole dermis and the subcutis and composed of partially confluent aggregates of matrical cells admixed with eosinophilic cornified material containing shadow cells. In addition, multinucleated giant cells, areas of calcification and metaplastic ossification, edema, and hemorrhage were also observed. On the basis of histopathologic features, the diagnosis of pilomatricoma was made. Our report highlights an unusual clinical appearance of pilomatricoma that made us consider a variety of primary or secondary cutaneous neoplasms in its differential diagnosis.     

Eosinophilic panniculitis associated with chronic recurrent parotitis

A 37-year-old woman presented with recurrent erythema nodosum-like lesions on her arms and legs that were preceded by chronic recurrent parotitis. Microscopic examination revealed a mixed lobular and septal panniculitis with many eosinophils and multiple eosinophilic flame figures similar to those seen in Wells' syndrome. The dermis was not involved. The classification, differential diagnosis, and possible pathomechanisms of eosinophilic panniculitis are discussed.     

Rare manifestation of hypereosinophilic syndrome: Diffuse-type hair loss with massive perifollicular eosinophils

A 46-year-old woman consulted our hospital with diffuse alopecia and blood eosinophilia. Histological examination of the scalp revealed dense eosinophilic infiltration around the hair follicles and in the surrounding subcutis. Oral corticosteroid was effective to reduce hair loss and blood eosinophilia, but these conditions immediately relapsed after ending treatment. In addition to alopecia, she had diarrhea and colitis showing histological findings of dense eosinophilic infiltrations in the submucosa. We diagnosed hypereosinophilic syndrome based on hypereosinophilia of blood and tissue with clinical symptoms of alopecia and diarrhea. We suppose diffuse alopecia showing massive eosinophilic infiltration around the hair follicle is a rare symptom of hypereosinophilic syndrome.     

Wells' syndrome: a clinical and histopathologic review of seven cases

Wells' syndrome, or eosinophilic cellulitis, is characterized clinically by an acute dermatitis resembling cellulitis, which evolves into violaceous plaques that resolve spontaneously without scarring. The histopathologic features are dynamic, starting with dermal edema and infiltration of eosinophils, the development of "flame figures," and finishing with the appearance of phagocytic histiocytes. We present the clinical and histopathologic features of seven cases of eosinophilic cellulitis.     

Surgical treatment of lower limb ischemia and abdominal aorta aneurysm in a patient suffering from eosinophilic fasciitis

We report on a 65-year-old woman with typical clinicopathologic features of eosinophilic fasciitis (Shulman syndrome) who suffered from lower limb ischemia and abdominal aorta aneurysm. Physical examination, laboratory data and histopathologic findings confirmed the diagnosis of eosinophilic fasciitis. The patient underwent aorto-bifemoral vascular prosthesis implantation. Tissue reactions associated with eosinophilic fasciitis produced serious disturbances of the implanted graft healing.     

嗜酸性肉芽肿性多血管炎一例

患者,女,29岁。头面、手足散在血疱样丘疹、结节3天。皮肤科检查：面部、手足散在绿豆至花生大丘疹、结节,质地稍硬,浸润明显,表面可见紫癜样改变,部分皮损破溃结痂。结合临床症状、实验室及组织病理检查,诊断为嗜酸性肉芽肿性多血管炎。     

误诊为血管瘤的嗜酸性粒细胞增多性血管淋巴样增生

报告1例误诊为血管瘤的嗜酸性粒细胞增多性血管淋巴样增生。患者男,40岁。左耳廓及左耳后多发结节伴瘙痒8个月。皮肤科检查:左耳廓及耳后散在多个黄豆至蚕豆大暗红色结节,表面光滑,质硬,孤立不融合,可推动,无压痛,部分皮损表面结痂。皮损组织病理检查:真皮内血管增生,内皮细胞肿胀,向管腔突出,血管周围及胶原纤维间淋巴组织细胞和嗜酸性粒细胞浸润。诊断:嗜酸性粒细胞增多性血管淋巴样增生。     

Pediatric Wells syndrome (eosinophilic cellulitis) after vaccination: A case report and review of the literature

A 4‐year‐old boy presented with erythematous vesicular plaques, ulceration, edema, and pruritus on the left foot and ankle 10 days after receiving the tetanus, diphtheria, pertussis, and polio; measles, mumps, rubella, and varicella; and hepatitis A/B vaccines. Biopsy showed eosinophilic infiltrates and flame figures, suggesting Wells syndrome. Patch testing showed a 1+ reaction to neomycin and aluminum hydroxide, with a recall reaction of Wells syndrome of the feet bilaterally. We report a rare case of pediatric Wells syndrome triggered by nonthimerosal vaccine components confirmed by patch testing.