儿童泛发型环状肉芽肿1例

报告1例儿童泛发型环状肉芽肿。患者男,8岁,双前臂丘疹偶痒5年余,泛发全身5月。专科情况:面部、躯干、四肢对称分布散在带光泽的丘疹,呈皮色或红棕色,部分小丘疹融合形成小的环状斑块,环中部皮肤扁平。病理组织检查示:真皮浅层部分胶原变性,周围淋巴组织细胞栅栏状排列,血管周围少量淋巴细胞。诊断为:泛发型环状肉芽肿。     

非感染性肉芽肿

20100633泛发性环状肉芽肿并发色素性毛表皮症1例/陈梅(东南大学临床医学院皮肤性病学教研室),王飞∥临床皮肤科杂志.-2009,38(11).-730～731男,47岁。全身泛发性淡红色环状丘疹20年。左肩部大面积色素沉着伴有粗毛,出生时即有。组织病理(红色环状丘疹):表皮未见明显异常;其皮上、中部见数个局灶性胶原纤维变性,周围有栅栏状排列的组织细胞、淋巴细胞及中性粒细胞环绕,符合环状肉芽肿表现。结合病史、临床表现及皮损组织病理检查结果确诊。图2参4(刘昕)20100634变应性肉芽肿病/王涛(中国医科院北京协和医学院北京协和医院皮肤科),刘跃华∥临床皮肤科杂志.-2009,38(11)     

播散型环状肉芽肿1例

报告播散型环状肉芽肿1例。患者男,54岁。以全身皮肤弥漫性丘疹1年余就诊。全身对称分布环状排列的数个圆滑群集小丘疹,中央皮肤稍凹陷,圆形,米粒大小,孤立或者融合。皮损组织病理示:真皮浅层不规则胶原纤维变性,周围组织细胞和淋巴细胞浸润,呈栅栏状排列在变性胶原纤维周围。诊断:播散型环状肉芽肿。     

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。     

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。     

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。     

泛发型环状肉芽肿1例

患者男,75岁,周身泛发丘疹2年余,既往糖尿病史3年余。周身可见大量针尖至黄豆大红色丘疹,少量皮疹融合成片状,以背部及四肢伸侧为著。皮损组织病理示:真皮内灶性胶原变性,其周围淋巴细胞、组织细胞、多核巨细胞呈栅栏状排列。诊断:泛发型环状肉芽肿。     

穿通性环状肉芽肿1例

临床资料 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，病变主要发生于真皮和皮下组织，病理示灶状胶原变性和栅栏状肉芽肿形成。穿通性环状肉芽肿是环状肉芽肿中一种特殊类型，较少见。我科遇到1例报道如下。     

泛发型环状肉芽肿1例

患者男，73岁，弥漫性红色丘疹、斑块10个月。躯干、上肢弥漫性鲜红色丘疹，大部分丘疹融合成斑块，边缘隆起，排列成环状，部分融合成网状。皮损组织病理示：表皮轻度角化过度，真皮浅层见栅栏状肉芽肿形成，并见多核巨细胞形成，血管及附属器周围见散在淋巴细胞浸润；阿新蓝染色阴性。诊断：环状肉芽肿。给予口服阿维A胶囊、维生素E软胶囊，外用卤米松乳膏等治疗后明显好转。     

环状肉芽肿伴色素减退

报告1例环状肉芽肿伴色素减退。患者女,51岁。双前臂及胸部环状丘疹1年余。皮肤科检查:双上肢前臂、双手背及胸部可见淡红色或褐色环状丘疹及斑块,表面光滑,界限清楚,中央稍凹陷,部分皮损中央可见色素减退斑。皮损组织病理检查:真皮浅层可见灶状胶原坏死灶,周围淋巴组织细胞栅栏状浸润。诊断:环状肉芽肿伴色素减退。     

Cryotherapy in the treatment of pyogenic granuloma

BACKGROUND: Pyogenic granuloma is a benign, acquired, proliferative vascular lesion of the skin and mucous membranes. Many different treatments have been used for pyogenic granuloma with variable success rates. OBJECTIVE: To evaluate the efficacy of cryotherapy in the treatment of pyogenic granuloma. METHODS: In a prospective observational study, 135 patients with pyogenic granuloma were treated with cryotherapy using liquid nitrogen. The patients were followed up every 3 weeks until 3 months after disappearance of the lesion. RESULTS: Complete resolution of the pyogenic granuloma was achieved in all patients after a mean of 1.58 treatments (range, 1-4 treatments). At the end of follow-up period, there was a flat imperceptible scar, smaller than the treated lesion, in 16 patients (11.8%). A hypertrophic scar, 3 mm in diameter, was observed in one patient. Hypopigmentation was observed in seven patients (5.1%). No other complication or side-effect was recorded in the study. CONCLUSIONS: We believe that pyogenic granuloma can be treated simply and effectively with cryotherapy.     

Granuloma annulare of the photoexposed areas in two liver transplant recipients

BACKGROUND: We report two cases of generalized granuloma annulare occurring in photoexposed areas in two liver transplant recipients. CASE REPORTS: Case 1 was a 65-year-old man who had undergone liver transplantation in 1992. He was given immunosuppressive and antihypertensive therapy. Within 18 months of transplantation, he developed a confluent rash with maculae on sun-exposed areas (neck opening, nape, arms) and sparing the undershirt area. Clinical examination was normal. Skin biopsy revealed a palissade infiltrate located in the middle and upper derma, suggestive of granuloma annulare, with elastophagocytosis patterns (orcein stain and ultrastructure study). Photoexposure granuloma was diagnosed. Case 2 was a 59-year-old man who had undergone liver tranplantation in 1994. He was given immunosuppressive and antihypertensive therapy and developed within 4 months a dark rash on the neck opening and nape, sparing photoprotected areas. Histopathology revealed granuloma annulare. Elastophagocytosis was disclosed by orcein stain and the ultrastructure study. DISCUSSION: This clinical presentation of granuloma annulare in two liver transplant recipients is unusual. We discuss the clinical and histopathological patterns observed in our two cases and the relationships between granuloma annulare and immunosuppression.     

Increased plasma fibronectin in diabetes mellitus, necrobiosis lipoidica and widespread granuloma annulare

The plasma level of fibronectin was measured in patients with granuloma annulare, necrobiosis lipoidica and diabetes mellitus and compared with levels in healthy controls. A significant increase was observed in necrobiosis lipoidica, generalised granuloma annulare and diabetes but not in patients with solitary lesions of granuloma annulare. The possible role of fibronectin in the development of micro-angiopathy is discussed.     

Actinic granuloma (O'Brien)

Twelve cases of actinic graculoma (O'Brien) are reported. It is concluded that actinic granuloma is a specific disease characterized by clinical lesions indistinguishable from granuloma annulare, but occurring on solar damaged skin. Histologically, clastic tissue is destroyed by the granulomatous process in actinic granuloma. But not in granuloma annulare. It would appear that actinic granuloma, granuloma multiforme, necrobiosis lipoidica of the face and scalp (Wilson-Jones) and Miescher's granuloma of the face (Mehregan and Altman) are the same desease.     

Generalized granuloma annulare with primary biliary cirrhosis

Fifty-six year-old woman had a wide spread nodular and papular eruption on the trunk and arms for one week. She had suffered from primary biliary cirrhosis (PBC) for 8 years. The clinical appearance of the eruption was that of generalized granuloma annulare. Skin biopsy revealed a palisading granuloma in the dermis consisting of suppressor/cytotoxic T cells, Langhans type giant cells, plasmacytoid epithelioid cells and phagocytic macrophages with immunohistochemical analysis and electron microscopy. Liver biopsy showed Scheuer's IIIrd stage of PBC without associated granuloma. In PBC granulomata at the portal area of the liver, lung, muscle, skin and so on has been reported. And the histological findings of the granuloma of this case consisted with that of reported cases. Therefore the skin granuloma in this case was assumed to be related to PBC.     

Granuloma annulare following BCG vaccination

BACKGROUND: Granuloma annulare following BCG vaccination or tuberculin skin tests is rarely reported in the literature. We describe three cases occurring in patients under the age of 6 years. CASE REPORTS: In the first two cases, granuloma annulare was initially localized at the vaccinal site, then generalized. In the third case, diagnosis was deep granuloma annulare localized far from the initial vaccination site, with recurrence following tuberculin test. In the three cases, diagnosis was made on the basis of clinical and histological elements. DISCUSSION: The relationship between granuloma annulare and BCG may seem evident when the eruption occurs at the vaccinal site, but remains difficult to prove. Diagnosis essentially relies on the absence of other classical etiologies and a compatible delay. When a vaccination such as BCG appears to be the cause of granuloma annulare, a possible cause would be injection trauma or a cell-mediated-delayed-hypersensitivity reaction to a specific antigen contained in the vaccine, leading to development of skin disorders such as granuloma annulare in predisposed subjects. Reports of granuloma annulare following BCG are uncommon but the incidence may be underestimated. In practice, diagnosis of granuloma annulare following BCG or tuberculin skin test cannot be established until BCG dissemination infection is ruled out, a necessary clinical and paraclinical step required in all cases of eruptions following this vaccination. Granuloma annulare is a benign complication requiring no treatment and does not constitute a contraindication for other usual vaccinations.     

Resolution of disseminated granuloma annulare following isotretinoin therapy

Disseminated granuloma annulare is often a chronic disorder that may prove refractory to treatment and lead to prolonged cosmetic disfigurement. In a patient with disseminated granuloma annulare that was unresponsive to multiple therapeutic regimens, administration of isotretinoin resulted in rapid clearing of nearly all lesions. To our knowledge this is the first reported case in which this agent was used to treat disseminated granuloma annulare.     

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。