黏液水肿性苔藓1例

患者男,55岁。双前臂肤色丘疹7年余。有糖尿病史。组织病理检查示真皮中上部较多黏蛋白沉积,粘蛋白阿新蓝染色阳性。诊断:黏液水肿性苔藓。     

黏液水肿性苔藓1例

患者女,60岁.因四肢、躯干丘疹1年,于2005年12月在广安门医院皮肤科就诊.患者1年前无明显诱因肩部出现密集白色粟粒大丘疹,后丘疹逐渐增多,遍及四肢、躯干.患者近半年来乏力,消瘦,记忆力减退,无头晕及吞咽困难.自觉瘙痒,双手中指肿胀.睡眠差,饮食及二便正常.既往体健,无甲亢病史.否认家族中有类似疾病史.     

黏液水肿性苔藓

黏液水肿性苔藓(Lichen myxedematosus,LM)又称丘疹性黏蛋白沉积症(papular mucinosis)、硬化性黏液水肿(sclemmyxedema)。临床以局限性或全身性苔藓样丘疹及硬皮病样改变,病理以皮肤中纤维母细胞增殖、酸性黏多糖过度沉积为特征。它是临床上比较少见的一种慢性进展性代谢障碍性疾病。     

限局性黏液水肿性苔藓1例

1 病历摘要患者男,18岁.因左颈部密集丘疹5年于2010年1月12日就诊.患者5年前无诱因于左颈部出现肤色密集丘疹,微痒,当地医院诊断为小棘苔藓,予0.025%维A酸等外用,维胺酯口服,皮损无明显改善.半年前皮疹开始渐增多扩展,呈群集性分布.既往体健,无甲亢病史.否认家族中有类似疾病史.体格检查:系统检查未见异常.皮肤科检查:左颈部见群集性分布的肤色粟粒大苔藓样丘疹,质软,表面有蜡样光泽,部分融合成扁平斑块(图1).实验室检查:血、尿、粪常规,血生化,免疫球蛋白,甲状腺功能,心电图均正常.皮损组织病理检查:表皮轻度乳头瘤样增生,表皮突轻度延长、增宽,真皮血管周围有少许慢性炎性细胞浸润.阿新蓝染色:真皮乳头有黏蛋白沉积(图2).诊断:黏液水肿性苔藓.治疗上外用0.1%维A酸(迪维)霜,目前仍在随访中.     

黏液水肿性苔藓1例

我们于2005年5月诊治1例黏液水肿性苔藓，现报道如下。     

苔藓样型黏液水肿性苔藓1例

患者男,32岁.颈、胸部粟粒至绿豆大丘疹20年,渐蔓延至背部、大腿及上肢,微痒,曾自行外用皮炎平及皮康霜等无效.     

黏液水肿性苔藓2例

报告2例黏液水肿性苔藓。例1.女,16岁。全身起丘疹、结节2个月,以手部结节损害为特征。例2．女,40岁。四肢、躯干丘疹3年,伴面部斑块1年,以眉间隆起的纵向斑块为特征。此2例患者的丘疹、结节组织病理检查均示真皮胶原纤维疏松,成纤维细胞增生,胶原纤维束间阿新蓝染色阳性。     

黏液水肿性苔藓1例

<正>1临床资料患者男,43岁,因面颈部、躯干、四肢丘疹2年,2015年4月于我院就诊。2年前患者无明显诱因于躯干部出现散在粟粒大小苔藓样丘疹,密集分布,无自觉症状,后皮疹逐渐增多向面部、颈部及四肢蔓延,且上肢、躯干部皮肤变硬,伴双手指端青紫及冰凉症状。曾于多家医院就诊,病情无明显好转,病程中无吞咽困难、呼吸困难、声嘶、体质量下降、关     

硬化性黏液水肿性苔藓1例

报告1例硬化性黏液水肿性苔藓。患者男,45岁。因全身密集苔藓样丘疹,浸润性斑块伴瘙痒1年余就诊。皮肤科检查见双眉间、鼻梁及下颌两侧呈硬性隆起。组织病理学检查示真皮上部胶原稀疏、水肿,胶原束排列紊乱,胶原束间隙增宽,成纤维细胞增生,阿新蓝染色阳性。系统检查无异常。     

黏液水肿性苔藓1例

1临床资料患者男,28岁。躯干、上肢及头面部丘疹、结节、斑块、皮肤变硬6年。6年前,无明显诱因患者的躯干、上肢起红斑及粟粒大小丘疹,密集分布,后丘疹逐渐融合成斑块,上肢及躯干部皮肤肥厚和变硬。曾于多家医院就诊,具体诊治不详,病情无明显好转,且新发皮疹逐渐扩展至面部。近3年来,患者逐渐出现张口及伸舌受限,并逐渐出现饮水呛咳及吞咽困难。否认呼吸困难、声嘶、体重下降、意识障碍、肌无力及关节痛等症状。     

Lichen myxedematosus (papular mucinosis): new concepts and perspectives for an old disease

Lichen myxedematosus (LM) is an idiopathic cutaneous mucinosis; its classification dates back to 1953, when Montgomery and Underwood distinguished 4 types of LM. In the literature, the terms LM, papular mucinosis, and scleromyxedema often have been used indiscriminately as synonyms, but most reported cases of LM or papular mucinosis without indication of the subtype appear in fact to be cases of scleromyxedema. Actually, LM includes 2 clinicopathologic subsets: a generalized papular and sclerodermoid form (the only one which should be called scleromyxedema) with systemic, even lethal, manifestations and a localized form, which does not run a disabling course. The localized form is subdivided into 4 subtypes: (1) a discrete papular form involving any site; (2) acral persistent papular mucinosis involving only the extensor surface of the hands and wrists; (3) papular mucinosis of infancy, a pediatric variant of the discrete form or the acral form of persistent papular mucinosis; and (4) nodular form. A third group of atypical or intermediate forms, not meeting the criteria for either scleromyxedema or the localized form, includes cases of (1) scleromyxedema without monoclonal gammopathy, (2) localized forms with monoclonal gammopathy and/or systemic symptoms, (3) localized forms with mixed features of the subtypes, and (4) not well-specified cases.     

金色苔藓1例

报告1例金色苔藓。患者男,18岁。双足背密集“辣椒粉”样金黄色点状斑疹,内踝处金色斑疹连成片状,无自觉症状。组织病理检查示表皮可见角栓,无明显增生,真皮上部呈带状分布的炎性细胞浸润,小血管周围见少量到中等量以淋巴细胞为主的单一核细胞浸润,可见红细胞外渗,Perls亚铁氰化钾染色可见大量染成蓝色的含铁血黄素。     

色素性扁平苔藓

报告1例色素性扁平苔藓。患者男,20岁。躯干及四肢出现褐色斑疹半年余,无自觉症状。皮肤科检查见躯干及四肢散在大小不一、边界清楚的褐色斑疹和斑片,部分呈条索状,部分皮损肥厚、浸润。皮损组织病理改变符合色素性扁平苔藓。     

Acral persistent papular mucinosis: a case report and literature review

Acral persistent papular mucinosis is a rare subtype of localized lichen myxedematosus. It shows symmetric, asymptomatic, chronic, ivory to flesh‐colored, 2–5 mm sized papules arranged on the dorsa of the hands and extensor aspects of the distal forearms. Thirty‐two cases including two from China, appear to fit the proposed diagnostic criteria. We report a 31‐year‐old Chinese woman who presented with papules on the extensor aspects of her hands and distal forearms. Histopathology revealed a circumscribed area in the upper and mid reticular dermis with splaying of collagen fibers caused by amorphous deposits. The material was mucin, as it stained positively with alcian blue at pH 2.5. The thyroid profile was normal, and there was no evidence for lupus erythematous. The lesions were treated with electrofulguration and resolved leaving mild scars; there has been no recurrence at follow‐up after one year. We also review the literature on this rare form of mucinosis.     

心脏支架术后扁平苔藓一例

患者,男,60岁。四肢紫红色扁平丘疹伴瘙痒2个月余。组织病理特点符合扁平苔藓。外用糠酸莫米松乳膏和复方蛇脂软膏,患者皮疹基本逐渐好转。患者冠脉支架术后20天出现典型的扁平苔藓皮损,植入的Xience支架主要由钛材料制成,推测皮损的出现可能与植入支架的材质有关。     

A Case of Lichen Myxedematosus with Clearly Exacerbated Skin Eruptions after UVB Irradiation

We report a 48-year-old male with typical lichen myxedematosus, liver dysfunction, and diabetes mellitus. His skin eruptions were clearly exacerbated after accidental over-irradiation by UVB. These findings were clinically and histologically confirmed. The pathogenesis is still unknown, but we consider it to be due to Koebner phenomenon.     

色素性扁平苔藓1例

报告1例色素性扁平苔藓。患者女68岁。胸背部、腋下起黑褐色斑疹半年余,无自觉症状。皮肤科检查见躯干及腑下米粒至蚕豆大黑褐色斑,呈圆形或椭圆形,躯干部皮损主要是向心性分布。组织病理改变符合色素性扁平苔藓。     

呈网状红斑改变的扁平苔藓

报告1例呈网状红斑改变的扁平苔藓。患者女,34岁。全身泛发网状红斑22年,伴瘙痒,有口腔黏膜及甲受累。皮肤科检查见全身泛发网状红斑,部分红斑消退后局部有轻度萎缩,散在水疱,尼氏征阴性。双手多个指甲甲板萎缩、吸收。上腭见片状糜烂面。组织病理检查示表皮变薄,基底细胞广泛液化变性,真皮浅层淋巴细胞呈带状浸润。诊断：扁平苔藓。给予阿维A40mg/d口服3个月后皮损明显变平,颜色变暗。