表现为获得性鱼鳞病的红皮病型结节病

报告1例以获得性鱼鳞病为首要表现的红皮病型结节病。患者女,27岁。双下肢片状鳞屑8个月。全身弥漫潮红、肿胀、脱屑,四肢、躯干散在较多皮下结节及肿块;腋下及腹股沟淋巴结增大;尿蛋白定量及肾功能均异常;心电图示心律异常;颈部B超示甲状腺非均质改变;CT示双腋窝淋巴结增大,纵隔内淋巴结增多,脾大;皮损组织病理检查和网状纤维染色确诊为结节病。经小剂量泼尼松治疗好转。     

青春期前反常性痤疮一例北大核心CSCD

患儿男,8岁,腋下、腹部、臀部丘疹、结节、囊肿、瘢痕3年。患者3年前无明显诱因于腋下出现散在的红色丘疹、结节、囊肿,无瘙痒等不适,当时未予诊治。1年前臀部、腹部出现红色丘疹、结节、囊肿,囊肿破溃流脓,就诊于当地医院,给予口服抗生素治疗（具体不详）后部分消退,其后病情反复发作,部分皮损遗留增生性、凹陷性瘢痕。     

泛发性环状型结节病

报告1例环状型为主要表现的泛发性多形性皮损的结节病。患者男,46岁。头面部、躯干、四肢出现红斑和结节10年。皮损组织病理诊断为结节病。胸部CT检查示多发结节影,纵隔、腹腔多处淋巴结增大。经小剂量泼尼松治疗好转。     

丘疹型皮肤结节病1例

结节病是一种病因未明的肉芽肿性疾病,可累及机体多个组织系统,约25%～30%的患者可以出现皮肤改变.近期我们诊治1例,现报道如下. 临床资料患者女,44岁.因全身多处丘疹、结节1年余,于2009年4月23日来我院就诊.1年多前患者偶然发现右侧腰背部出现数个碗豆大小的皮下结节,中等硬度.无自觉症状.皮疹逐渐增多、增大、并蔓延至躯干及四肢,皮损呈紫红色.在当地医院诊断为痒疹,治疗后症状无缓解.为进一步治疗入我院.既往史：2年前,患者因左侧颈部淋巴结肿大在当地医院行CT检查示：纵膈广泛淋巴结肿大伴双肺改变.予以抗结核治疗.家族中无类似疾病史.     

丘疹型皮肤结节病1例

结节病是一种病因未明的肉芽肿性疾病,可累及机体多个组织系统,约25%～30%的患者可以出现皮肤改变.近期我们诊治1例,现报道如下. 临床资料患者女,44岁.因全身多处丘疹、结节1年余,于2009年4月23日来我院就诊.1年多前患者偶然发现右侧腰背部出现数个碗豆大小的皮下结节,中等硬度.无自觉症状.皮疹逐渐增多、增大、并蔓延至躯干及四肢,皮损呈紫红色.在当地医院诊断为痒疹,治疗后症状无缓解.为进一步治疗入我院.既往史:2年前,患者因左侧颈部淋巴结肿大在当地医院行CT检查示:纵膈广泛淋巴结肿大伴双肺改变.予以抗结核治疗.家族中无类似疾病史.     

毛囊闭锁三联征1例

患者男,21 岁.头皮、躯干斑块及脓肿5 年入院.患者5 年前无明显诱因胸、背部出现较密集的黄豆至花生米大的丘疹、结节,结节逐渐形成脓肿,破溃后有脓液流出,伴压痛,皮损缓慢愈合,形成大小不一、表面光滑的斑块,上述皮损散在出现于四肢、腋下及臀部.     

淋巴瘤样丘疹病1例

患者男,48岁。因躯干和四肢反复出现红斑,丘疹、结节3年,于2004年6月28日至我院就诊。3年前患者无明显诱因,躯干、四肢出现散在孤立的红色丘疹、结节,皮损大小不等,中央有坏死结痂,愈后留有色素沉着和瘢痕。在当地医院诊断为急性痘疮性苔藓样糠疹,未予治疗,皮损数周后消退。     

多发性皮肤平滑肌瘤1例

正1临床资料患者男,44岁。躯干、双上肢多发性丘疹伴疼痛30年余。患者30多年前无明显诱因右侧上肢外侧出现数个米粒大红色丘疹,渐增多,轻微疼痛,未曾诊治。近1年来红色丘疹明显增多,累及左侧躯干部、右侧肩胛部,部分皮损增大,形成数百个米粒至豌豆大小结节,疼痛加剧,呈阵发性针刺样,受冷时为甚。1年前曾于"诊所"行激光治疗去除左侧躯干部的皮损,但很快复发,且原皮损处形成条索状瘢痕。既往史无特殊,家族     

嗜酸粒细胞增多性皮炎1例

临床资料患者女,33岁。因全身反复起红斑、丘疹,伴瘙痒2年,皮损再发2周于2005年4月入院。2年前无明显诱因双腋下出现小片状红斑、丘疹,微痒,皮疹初为散在,渐累及躯干及四肢,融合成环状、半环状,皮疹可自行消退。此后全身反复起环形红斑、丘疹,先后诊断为过敏性皮炎、玫瑰糠疹、     

红皮病型结节病二例并文献复习

两例患者(男女各1例)表现为红斑、丘疹及脱屑,伴轻微瘙痒,皮肤组织病理特点符合结节病诊断。男性患者胸部CT示双下肺少许间质病变。女性患者胸部CT示两肺散在小结节影,双腋窝淋巴结增大。两例患者糖皮质激素治疗均有效。     

Sarcoidosis with subcutaneous lesions

A 30-year-old man presented for evaluation of multiple, hypopigmented macules and erythematous papules on his upper and lower lips and upper extremities. He subsequently developed firm, non-tender, subcutaneous, mobile nodules on the left forearm, left calf, and right thigh. Clinical and histopathologic features were consistent with cutaneous and subcutaneous sarcoidosis. Systemic evaluation showed no evidence of extracutaneous involvement. Subcutaneous sarcoidosis is a rare form of nodular cutaneous sarcoidosis. Typical skin findings are painless, firm, mobile nodules without overlying epidermal involvement and with a predilection for the trunk and extremities. Histopathologic alterations include epilthelioid cell tubercles in the subcutaneous fat. As this is a diagnosis of exclusion, other etiologies of granulomatous inflammation must be ruled out with tests and special stains. The mainstay of treatment is with oral glucocorticoids.     

Atypical multicentric reticulohistiocytosis

A 38-year-old male had arthritis since 8 years and erythematous papules, plaques, cutaneous and subcutaneous nodules over face, ears, trunk, and extensors of arms since 2 years, Histopathologically, presence of multiple foreign body giant cells confirmed the clinical diagnosis of multicentric reticulohistiocytosis. Unusual associations were: tapered fingers with depressed scars on their tips, low ESR - (5mm 1st hour). Raynaud's phenomenon and exaggeration of lesions after methotrexate.     

Segmental Juvenile Xanthogranuloma

A 5‐month‐old boy had erythematous nodules over the left side of his trunk with a segmental arrangement since birth. Histopathologic examination revealed sheets of foamy histiocytes infiltrating the dermis and subcutaneous fat, admixed with multinucleated giant cells and lymphocytes, making this an unusual case of juvenile xanthogranuloma appearing in a segmental distribution.     

Churg‐Strauss syndrome presenting as scar reactivation: histopathologic features and an illustration of ‘locus minoris resistentiae’

We report a 33‐year‐old female with cutaneous involvement by Churg‐Strauss syndrome confined to surgical scars that were obtained 13 years before. She presented to the emergency department with 2‐day history of fever, night sweats, right‐sided weakness, hoarseness and worsening asthma symptoms. She was found to have an eosinophilia and two sub‐5‐mm pulmonary nodules. The patient also reported that the scars on her right thumb, inner wrist and back had been swollen, red and painful for 2 days. Examination revealed tender, erythematous, well‐healed edematous scars studded with small skin colored papules. She had no clinical findings that were classic for cutaneous vasculitis. A skin biopsy of a scar revealed perivascular and palisading granulomatous inflammation consisting of histiocytes and neutrophils with leukocytoclasia. Focal vascular injury was identified. Scattered tissue eosinophils were seen. Special stains were negative for infection. Thereafter, she was started on intravenous steroids, at which point the fever, pulmonary and cutaneous symptoms subsided. Although scar sarcoidosis is a well‐described phenomenon, granulomatous inflammation and vasculitis seen in Churg‐Strauss syndrome exclusively manifesting in well‐healed surgical scars highlights the unique features seen in this case and draws attention to the concept of locus minoris resistentiae. This case also highlights how a skin biopsy in the setting of suspected systemic vasculitis can confirm the presence of vasculitis and/or granulomatous inflammation and obviate the need for more invasive, higher risk procedures such as lung biopsy.     

表现为红斑和皮下结节的结节病一例

报告1例同时表现为红斑和皮下结节的结节病。患者女,55岁。左眉暗红斑,颞部多发皮下结节2个月余。皮肤科检查:左侧眉弓直径约1 cm暗红斑,颞部多发皮下结节,直径0.5~1.5 cm,质硬,边缘不规则。皮损组织病理示:真皮或皮下脂肪层大量的上皮样细胞肉芽肿及多核巨细胞浸润,大部分呈裸结节。诊断:结节病。     

Dermatofibrosarcoma Protuberans Arising from a Burn Scar

Malignant neoplasms arising in burn scars are well known. In previous literature, 25 cases of burn scar sarcomas were reported. However, dermatofibrosarcoma protuberans is very rare and only two cases have been reported. A 43-year-old Korean man presented with multiple erythematous clustered plaques and nodules and a skin-colored subcutaneous mass on the chest after a severe burn injury at the age of 8 years. A biopsy specimen revealed dermatofibrosarcoma protuberans. The tumor was excised widely to include the surrounding burn scar. Herein, we report this third case of dermatofibrosarcoma protuberans arising from a burn scar.     

Foreign bodies in granulomatous cutaneous lesions of patients with systemic sarcoidosis

OBJECTIVE: To assess the presence of foreign material in the granulomatous cutaneous lesions of patients with systemic sarcoidosis. DESIGN AND SETTING: Observational study reevaluating histological specimens at a university referral hospital. PATIENTS: Sixty-five patients diagnosed as having sarcoidosis who developed granulomatous cutaneous involvement. MAIN OUTCOME MEASURES: To detect the presence of polarizable foreign particles in cutaneous biopsy specimens and to evaluate the association with clinical features of the patients. RESULTS: Granulomatous cutaneous involvement was demonstrated in 65 (15.3%) of 425 patients with systemic sarcoidosis. In 14 (22%) of the 65 patients, the cutaneous biopsy specimen showed foreign particles in polarized light. The skin lesions corresponded to 3 different clinical patterns: an admixture of papules and infiltration of previously undetected minute scars (n = 6); scar sarcoidosis (n = 4); and subcutaneous nodules (n = 4). The lesions were located most frequently in the extremities, involving the knees in 10 patients. CONCLUSIONS: The presence of polarizable foreign body material in granulomatous cutaneous lesions is not infrequent in patients with systemic sarcoidosis. Inoculation of foreign matter from a previous inapparent minor trauma may induce granuloma formation in individuals with sarcoidosis.     

Blau综合征一例

患儿女,4岁,全身皮肤弥漫性丘疹、红斑、脱屑,大关节处皮下结节伴进行性眼损害3年。患儿出生后3个月出现下肢丘疹,逐渐累及全身。一次高热后出现眼部病变,诊断为双角膜白斑,陈旧性虹膜炎,虹膜后粘连。体检：双角膜散在灰白色混浊,边界清,前房浅,虹膜斑不清,瞳孔不圆,有后粘连。全身浅表淋巴结不大。皮肤科检查：全身弥漫性丘疹、红斑、脱屑、表面粗糙,似鱼鳞病,皮肤皱纹增多,皮温较高,无汗。腕、踝、膝关节部位大小不等的包块,质软,可活动。无红肿疼痛等症状。双眼B超显示双玻璃体混浊,双玻璃体后脱离,玻璃体后界膜下渗出,眼压降低。背部、腰部及手背部皮损及腕部皮下结节活检示：表皮棘层增厚,真皮内可见大量组织细胞、泡沫细胞及多核巨细胞浸润。其余检查无明显异常。诊断：Blau 综合征。此病为常染色体显性遗传性疾病,目前无有效的治疗方法。     

Propranolol: a novel treatment for angiolymphoid hyperplasia with eosinophilia

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon, idiopathic disease that manifests as dermal or subcutaneous red or brown papules or nodules, most commonly on the head and neck. Histologically, ALHE is characterized by vascular proliferation with epithelioid endothelial cells with surrounding lymphocytic and eosinophilic infiltrate. There may be an accompanying serum eosinophilia and local lymphadenopathy. We report a case of a 32‐year‐old woman who presented with multiple erythematous nodules in the periauricular area and the vertex of her scalp. The nodules had been present for several months. Surgical removal of one of the lesions confirmed the histological diagnosis of ALHE. The patient was started on oral propranolol (40 mg once daily) in an effort to reduce the vascular component of the lesions. Within 6 weeks, the patient noted that several of the lesions had decreased in size, and all were less erythematous. Propranolol was subsequently stopped within a few months of initiating treatment. One lesion recurred over a year later, and propranolol was then restarted. No new lesions occurred after 2 years of follow‐up.     

类风湿性嗜中性皮炎一例

患者女,62岁.面、躯干及四肢红色斑丘疹10年,加重2年.患者有类风湿关节炎病史20年,同时合并有干燥综合征、Ⅱ型糖尿病、间质性肺炎、慢性肾功能不全等疾病.皮肤科检查:面颈、躯干、四肢泛发粟粒至绿豆大小水肿性红斑、丘疹、斑丘疹,局部散在浸润性结节,以背部为著.双上肢伸侧、双膝及股臀部弥漫大片暗红斑.双手足、肘膝关节、双耳等处可见鸽卵大小暗红色或黑褐色疼痛性结节.类风湿因子阳性.皮损组织病理示,真皮上部弥漫淋巴细胞、中性粒细胞浸润,可见少许核尘及红细胞外溢,无血管炎表现.结合病史、皮损特点、实验室检查、皮损组织病理检查,确诊为类风湿性嗜中性皮炎.