环状弹性纤维溶解性巨细胞肉芽肿

报告10例环状弹性纤维溶解性巨细胞肉芽肿.男4例,女6例,年龄29～77岁.大多数患者皮损表现为大小不一的环状斑块,中央轻度萎缩,遗留色素减退,周围有一轻度隆起的红色边缘.皮损最常见于双手背和躯干.组织病理检查显示真皮中上层的间质中有组织细胞、多核巨细胞和淋巴细胞浸润,皮损中央弹性纤维减少或缺失,并且可见多核巨细胞吞噬弹性纤维的碎片;未见渐进性坏死和黏蛋白沉积.该文报告的10例患者临床表现和组织病理学改变均符合环状弹性纤维溶解性巨细胞肉芽肿的诊断.     

环状弹性纤维溶解性巨细胞肉芽肿

报告1例环状弹性纤维溶解性巨细胞肉芽肿。患者男,59岁。躯干、四肢起红色丘疹和环状斑块4年余,加重1年。皮损组织病理检查示真皮浅中层可见散在分布较多淋巴细胞、组织细胞、上皮样细胞和局部群集的多核巨细胞浸润。阿辛蓝染色阴性。弹性纤维染色示真皮浅中层弹性纤维明显减少、缺失,部分多核巨细胞内可见吞噬的弹性纤维。结合临床、组织病理、阿辛蓝染色和弹性纤维染色,诊断为环状弹性纤维溶解性巨细胞肉芽肿。临床上,该病需与环状肉芽肿和光化性肉芽肿鉴别。     

环状弹性纤维溶解性巨细胞肉芽肿1例

患者女,55岁。面部红色肿块8个月。皮损组织病理示:真皮下部以多核巨细胞为主的肉芽肿性浸润。特殊染色显示:真皮中下部弹力纤维减少、断裂或消失。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

环状弹性纤维溶解性巨细胞肉芽肿1例

患者女,45岁,双侧颈部、双手背多发淡红色及皮色扁平丘疹1个月。皮损组织病理示:表皮大致正常,真皮中上层胶原束间可见多量多核巨细胞、淋巴细胞、组织细胞浸润,并可见多核巨细胞吞噬弹性纤维碎片现象,弹力纤维染色示肉芽肿区弹力纤维减少,阿新蓝染色未见明显黏蛋白沉积。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

泛发型环状肉芽肿2例

环状肉芽肿是以环状丘疹或结节性损害为特征的慢性皮肤病,其中泛发型环状肉芽肿临床较少见。本文报道2例女性泛发型环状肉芽肿病例,皮损表现为躯干四肢弥漫的丘疹、环状斑块。甲状腺功能、EB病毒及巨细胞病毒抗体、血糖血脂检查均未见异常。组织病理表现为真皮浅中层栅栏样肉芽肿形成,中央结缔组织变性,周围上皮样细胞,多核巨细胞及淋巴组织细胞浸润。     

环状弹性组织溶解性巨细胞肉芽肿1例

患者男,50岁。双手背部及颈部多发环形红斑2年余。颈部皮损组织病理示:真皮浅层见较多的多核巨细胞浸润,可见吞噬,特殊染色显示弹性纤维碎裂和吞噬。诊断:环状弹性组织溶解性巨细胞肉芽肿。予中药活血散结治疗,症状较前好转。     

额部环状弹性纤维溶解性巨细胞肉芽肿1例

患者男,58岁。额部反复出现多发性环形红斑13年余。皮损组织病理示:表皮大致正常,真皮浅层较多淋巴细胞灶性浸润,真皮内见两处肉芽肿样病变,由较多多核巨细胞和部分淋巴细胞构成,未见坏死。弹力纤维染色示:多核巨细胞内可见吞噬现象。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

泛发性环状肉芽肿1例

患者女,52岁,躯干、四肢出现红色环状浸润性斑块伴痒痛2年。皮损组织病理示:表皮基本正常,真皮内多处灶性胶原纤维变性,周围有淋巴细胞、组织细胞浸润,呈栅栏状排列,有极少量多核巨细胞浸润。诊断:泛发性环状肉芽肿。     

环状弹性纤维溶解性巨细胞肉芽肿1例

患者女,54岁。额头、颈部、双手背部环状皮损半年余。皮肤科情况:额头、颈部、双手背部,可见数个环状皮损连结成片,形状不规则,大小不等,大者直径约3cm,小者黄豆大小,色淡红,边界较清晰、略隆起、呈堤坝状、无脱屑。皮损组织病理示:真皮内可见弹性纤维变性、碎裂,并可见巨噬细胞吞噬变性弹性纤维现象。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

环状弹性纤维溶解性巨细胞肉芽肿1例

环状弹性纤维溶解性巨细胞肉芽肿(annular elastolytic siam cell granuloma,AEGCG)是临床少见的肉芽肿性皮肤病,组织病理表现可见弹性纤维溶解和多核巨细胞吞噬弹性纤维,临床上容易误诊和漏诊.现将笔者诊治的l例报告如下.     

Annular elastolytic giant cell granuloma: an unusual case with papular lesions.

A 63-year-old Japanese woman with multiple annular lesions on the bilateral abdomen developed numerous papules on the upper part of the back and forearms. A skin biopsy specimen taken from a papule showed the findings of annular elastolytic giant cell granuloma.     

Eosinophilic annular erythema

Eosinophilic annular erythema is a rare benign recurrent disease, originally described in children, characterized by the recurrent appearance of persistent non-pruritic, urticarial annular lesions. Histologically a perivascular infiltrate composed of lymphocytes and abundant eosinophils in the dermis is exhibited. We report the case of a 15-year-old boy who presented with a 4-year history of recurrent flares of erythematous annular plaques on the trunk and extremities. The lesions resolved spontaneously after 3-5 weeks with no accompanying signs. A biopsy showed a mainly perivascular lymphocytic infiltrate with numerous eosinophils in the dermis.     

Annular pustules in Kawasaki disease: a further case indicating the association with psoriasis?

We report the case of a 4-year-old girl with Kawasaki disease (KD), or mucocutaneous lymph node syndrome, who presented with an annular pustular eruption. Targetlike erythematous and scaly patches were observed after resolution of the pustules. A biopsy of the skin was performed, and results showed spongy pustules not associated with the intraepidermal eccrine duct. Generalized pustular eruption, including pustular psoriatic lesions, has been described in KD. However, to our knowledge, this is the first report of annular pustular eruption mimicking annular pustular psoriasis in KD.     

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.     

羟氯喹联合外用糖皮质激素治疗儿童泛发型环状肉芽肿一例并文献复习

报道1例羟氯喹联合外用糖皮质激素治疗儿童泛发型环状肉芽肿并对相关文献进行复习。患儿,男,8岁。躯干、四肢泛发性环状斑片2个月。组织病理检查：真皮内见上皮样肉芽肿,中央胶原纤维变性、坏死,肉芽肿周围组织细胞、淋巴细胞浸润,胶原纤维增生,胶原间散在单一核细胞浸润。诊断：泛发型环状肉芽肿。给予硫酸羟氯喹片0.1 g/d口服,皮损外用复方丙酸氯倍他索软膏,1个月后复诊明显好转。继续治疗并随访。     

Primary annular plaque-type psoriasis

We described two adolescent girls with untreated, consistently annular, plaque-type psoriasis without pustules, a presentation that is to our knowledge, not previously described. No typical confluent plaque-type lesions were present. The plaques in our patients resembled other entities such as tinea corporis and erythema annulare centrifugum, given the erythematous, scaling borders and central clearing. Biopsy specimens from our patients showed features characteristic of psoriasis vulgaris. Both patients responded to combination therapy with calcipotriene and a mid-potency steroid. We conclude that primary annular plaque-type psoriasis shares features of both typical plaque-type and annular pustular psoriasis, suggesting that these entities represent a spectrum of psoriatic disease.     

Papular elastolytic giant cell granuloma: a clinical variant of annular elastolytic giant cell granuloma or generalized granuloma annulare?

A 71-year-old man with asymptomatic red papules on the trunk and upper arms was reported as a case of papular elastolytic giant cell granuloma. A skin biopsy specimen from a papule on the back showed similar findings to those of annular elastolytic giant cell granuloma. However, centrifugal annular lesions were not clinically observed. He was successfully treated with tranilast and topical steroids.     

Preceding Annular Skin Lesions in a Patient with Hemophagocytic Lymphohistiocytosis

The cutaneous manifestations of hemophagocytic lymphohistiocytosis (HLH) are variable and nonspecific. A 42-year-old man presented with multiple annular, erythematous patches on the trunk for 3 months. Two months later, he presented with bullae along with high fever. The laboratory examination showed pancytopenia, hypertriglyceridemia, and hypofibrinogenemia. The bone marrow biopsy specimen showed an active hemophagocytosis. On the basis of these findings, a diagnosis of HLH was concluded. After five cycles of chemotherapy, his skin lesion completely resolved. Taking the results together, we suggest that annular skin lesion can be added to the list of cutaneous manifestations of HLH.     

阿达木单抗治疗泛发型环状肉芽肿一例并文献复习

［摘要］报道一例使用阿达木单抗治疗泛发型环状肉芽肿并复习相关文献。患者，男，76岁。躯干、四肢泛发型环状红斑、丘疹，境界清楚，组织病理示：表皮轻度增生,真皮内见上皮样肉芽肿,中央胶原纤维变性、坏死,肉芽肿周围组织细胞、淋巴细胞浸润,胶原纤维增生，胶原间散在单一核细胞浸润。诊断为泛发型环状肉芽肿。第0周给予阿达木单抗注射液80 mg皮下注射，第1、3、5、7、9周给予阿达木单抗注射液40 mg皮下注射。随访3个月后患者皮损基本消退、遗留少量色素沉着。