儿童肉芽肿性口周皮炎18例临床分析  

Clinical Analysis of 18 Cases Childhood Granulomatous Periorificial Dermatitis

作　　者：陈见友 苏伟[1] 张高磊[1] 邓维 高莹[1] 刘晓雁[1] CHEN Jianyou;SU Wei;ZHANG Gaolei;DENG Wei;GAO Ying;LIU Xiaoyan(Department of Dermatology,Children,s Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院皮肤科,北京100020

出　　处：《中国皮肤性病学杂志》2022年第12期1402-1407,共6页The Chinese Journal of Dermatovenereology

摘　　要：目的 探讨儿童肉芽肿性口周皮炎的临床表现、病理特征、治疗及预后。方法 回顾性分析2018年6月-2019年12月首都儿科研究所附属儿童医院皮肤科诊治的18例肉芽肿性口周皮炎患儿的临床特点、皮肤镜特点、组织病理学特征、治疗方法以及预后。结果 18例患儿中男11例,女7例,面部腔口周围直径1~3 mm大小的坚实小丘疹,簇集分布。所有患儿系统检查均无异常。皮肤镜检查示:皮损部位可以看到多发圆形均质的橙黄色区域,周围伴或不伴红晕及鳞屑。皮损组织病理示:表皮大致正常,真皮浅中层及毛囊周围见非干酪样肉芽肿,由组织细胞、多核巨细胞及淋巴细胞组成。18例患儿均给予外用0.03%浓度的他克莫司软膏和/或联合口服阿奇霉素治疗,随访2年,均无复发。其中2例患儿愈后皮损部位出现了色素沉着及瘢痕。结论 儿童肉芽肿性口周皮炎属良性自限性皮肤病,具有独特的临床表现、皮肤镜特征和病理特征。根据皮损类型选择不同的治疗方案,建议尽早治疗,可以缩短病程,减少后遗皮肤表现的发生,主要为色素沉着,偶尔出现凹陷性瘢痕。Objective To investigate the clinical manifestations, pathological features, treatment and prognosis of childhood granulomatous periorificial dermatitis(CGPD).Methods A total of 18 CGPD patients from Department of Dermatology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from June 2018 to December 2019 were analysed retrospectively.Results Among the 18 patients, 11 were male and 7 were female, with small pink indurated papules measuring 1-3 mm in diameter in the periorificial region. There were no abnormalities in all systemic examinations.Dermoscopy revealed multiple roundish, homogeneous, orangish areas with or without reddish background and scaling.Histopathological examination of an erythematous papule showed non-caseating granulomas containing histiocytes, multinucleated giant cell and focally surrounded lymphocytes. Periadnexal and perivascular lymphocytic infiltrate was also present. Stains for fungi and acid-fast bacilli were negative. All 18 patients were treated with topical tacrolimus ointment and/or oral azithromycin, and no recurrence was found during a 2-year follow-up.However, pigmentation and scarring were observed in 2 cases after recovery.Conclusion CGPD is a skin disease with unique clinical, dermoscopy and pathological features. Treatment options vary depending on the type of skin rash.Cutaneous sequelae can occur after skin involvement of CGPD, and mainly includes pigmentation abnormality with occasional pitting scars.

关 键 词：口周皮炎 肉芽肿性口周皮炎 儿童 色素沉着 他克莫司 阿奇霉素 

分 类 号：R751[医药卫生—皮肤病学与性病学]