复发性线状棘层松解性皮病临床分析(附1例报告)

目的：提高对复发性线状棘层松解性皮病的认识，探讨其诊断依据和有效的治疗方法。方法：就1例复发性线状棘层松解性皮病患者及相关文献进行临床分析，在病因、诊断及治疗等方面对本病进行讨论分析。结果：本例为6个月大男性患儿，右臀部至胭窝，右肘关节伸侧以及右胸腹部见沿Bias-chko线分布的暗红斑、水疱、糜烂和浅溃疡，组织病理学改变同Hailey-Hailey病（家族性慢性良性天疱疮），经适量皮质类固醇激素及敏感抗生素治疗后缓解；本病自1985年首例报道以来，至今国内外仅有5例报告，皮损均具有沿Blaschko线呈单侧分布的特征。结论：复发性线状棘层松解性皮病是一种极为罕见的、反复发作的痣样疾病，皮疹以沿Blaschko线分布伴有水疱和糜烂的红色斑块为特征，组织病理具有不完全棘层松解，倒塌的砖墙样改变，与Hailey-Hailey病不能区别，两者的诊断主要依据其特征性的临床表现。     

复发性线状棘层松解性皮病一例

复发性线状棘层松解性皮病是一种比较少见的疾病。患儿,女,6岁。右侧臀部、股后红色斑块反复5年余,加重2个月。皮肤科检查：右侧臀、股后部、腘窝见条索状分布的暗红色斑块,上覆白色鳞屑,局部结血痂,散见色素沉着斑,皮损沿Blaschko线分布。组织病理学检查示：表皮角化过度、角化不全,棘层松解呈砖墙倒塌样。直接免疫荧光(DIF)阴性。     

暂时性棘层松解性皮病1例

患者男,58岁。面部、躯干、四肢出现红色斑疹、丘疹及丘疱疹2个月,无痒感。皮损组织病理见局灶性基底细胞层上裂隙,少量棘层松解细胞,直接和间接免疫荧光检查阴性。诊断为暂时性棘层松解性皮病。结合本例特点进行相关文献复习。     

暂时性棘层松解性皮病1例

报道1例暂时性棘层松解性皮病，以丘疹为主要临床表现，病理见局限性基底细胞层上裂缝，少量棘层松解细胞。     

暂时性棘层松解性皮病1例并文献复习

报道1例暂时性棘层松解性皮病,并对国内外相关文献进行复习回顾。本例患者以丘疹、丘疱疹、水疱为主要临床表现,病理见局限性基底细胞层上裂隙,少量棘层松解细胞,表皮内水疱。     

暂时性棘层松解性皮病一例

临床资料 患者,男,70岁。主因头皮、前额斑丘疹伴瘙痒6个月,于2011年3月9日就疹。患者6个月前无显明诱因头皮、前额出现斑丘疹,伴轻度瘙痒,     

暂时性棘层松解性皮病

暂时性棘层松解性皮病（transient acantholytic dermatosis,TAD）病因不明,临床上主要表现为丘疹、丘疱疹、水疱等。组织病理学改变多种多样,可类似天疱疮、家族性良性天疱疮或毛囊角化病（Darter病）。治疗以外用或口服糖皮质激素、维A酸制剂为主。     

外生殖器部位棘层松解性皮病

报告1例外生殖部位棘层松解性皮病。患者女,54岁。外阴灰白色、肤色丘疹伴瘙痒8个月。皮肤科检查：双侧大阴唇可见暗红色水肿性红斑,边界清楚,红斑上散在线状排列的米粒至黄豆大肤色、苍白色圆形扁平丘疹,表面光滑,质地较硬;部分丘疹融合形成斑块,呈苔藓样变,散在抓痕、糜烂。皮损组织病理检查：表皮灶性角化过度、角化不全,棘层肥厚,棘细胞松解,角化不良,表皮下血管增生,淋巴细胞浸润。直接免疫荧光检查示阴性。诊断：外生殖器部位棘层松解性皮病。     

外生殖器部位的棘层松解性皮病

报告1例发生于外生殖器部位的棘层松解性皮病.患者女,311.外阴、肛周出现灰白色丘疹6个月,无明显疼痛、瘙痒等不适,部分皮损轻度糜烂、结痂.皮损组织病理检查:表皮灶性角化过度、角化不全,棘层肥厚,棘细胞松解,角化不良.表皮下血管增生,淋巴细胞浸润,直接免疫荧光检查阴性.     

外生殖器部位的棘层松解性皮病1例并文献复习

患者女,20岁,外阴丘疹伴瘙痒5年,加重数月。皮肤科情况:大阴唇、会阴见多发性群集分布的绿豆至黄豆大小灰白色扁平圆形丘疹。皮损组织病理示:表皮角化过度伴角化不全,棘层增生肥厚,可见棘层松解,真皮浅层较多淋巴细胞浸润。诊断:外生殖器部位的棘层松解性皮病。     

暂时性棘层松解性皮肤病

报告1例暂时性棘层松解性皮肤病。患者男，43岁。因驱干和四肢出现红斑、丘疹、水疱伴瘙痒1个月就诊。皮损组织病理检查见表皮局灶性棘层松解，直接和间接免疫光学检查均阴性，诊断为暂时性棘层松解性皮肤病（Crover病）。结合本例临床特点进行文献复习。     

Pseudoherpetic transient acantholytic dermatosis (Grover disease): case series and review of the literature

A total of 3 cases of pseudoherpetic transient acantholytic dermatosis (Grover disease) are presented, followed by a brief review of prior reports. All 3 patients were above the age of 60 and presented with a pruritic eruption composed of papules with or without vesicles distributed on the trunk. For all 3 patients, the clinical differential diagnosis included drug eruption but did not include Grover disease; in 1 patient, the clinical impression included herpesvirus infection. Similar histologic and immunohistochemical findings were demonstrated in all 3 cases. Intraepidermal vesicles with acantholysis, multinucleation and hypereosinophilic keratinocytes mimicking necrosis raised the possibility of herpesvirus infection. However, the focality of the process at scanning magnification, absence of true cytopathic effect despite multinucleation, and identification of dyskeratosis rather than true necrosis all permitted for morphologic distinction as pseudoherpetic change. Immunohistochemistry, negative for herpes simplex virus and varicella zoster virus antigens, also distinguished pseudoherpetic change in these patients from a true herpesvirus infection. This series highlights an uncommon histologic variant of a common disorder and describes morphologic and immunohistochemical findings to facilitate its distinction from true herpesvirus infection.     

Relapsing linear acantholytic dermatosis

A 5-year-old girl with a unilateral linear systematized skin lesion showing the clinical, histological and ultrastructural features of Hailey-Hailey disease is described. We suggest that this relapsing linear acantholytic dermatosis represents a new distinct entity within the spectrum of unilateral linear skin diseases.     

Effective treatment of persistent papular acantholytic dermatosis with cyclosporine

We describe a patient with persistent papular acantholytic dermatosis provoked by phototoxic reaction to his usual perfumed soap and shaving foam. Therapy with systemic and topical corticosteroids failed to improve the patient. Treatment with cyclosporine was found to be effective.     

Zosteriform persistent acantholytic dermatosis and porphyria cutanea tarda

Our case refers to a 77 year-old man with a history of porphyria cutanea tarda (PCT) who presented with pruritic eruption consisting of erythematous papules localized in a zosteriform area on the right part of the trunk which had appeared three years previously. He gave a history of long exposure to the sun. A biopsy showed a spongiotic pattern, dyskeratotic acantholytic cells and corp ronds in the granular layer. Diagnosis of persistent acantholytic dermatosis (Grover's disease) was made. To the best of our knowledge no case of association of PCT and persistent Grover's disease has been previously described in the dermatologic literature.     

Transient acantholytic dermatosis (Grover's disease) in a renal transplant patient

Grover's disease ("transient acantholytic dermatosis") is a transient dermatosis of unknown cause manifesting clinically as a papular skin eruption located usually on the anterior chest and abdomen and histologically with dyskeratosis and acantholysis. Grover's disease has occasionally been reported in patients with chronic renal failure, HIV infection, hematological malignancies and bone-marrow allotransplantation. We report herein a new case of Grover's disease that developed in a renal transplant patient. To the best of our knowledge, this is the first observation of Grover's disease developing in the setting of solid organ transplantation.