化脓性汗腺炎4例临床分析  

Clinical Analysis of 4 Cases of Hidradenitis Suppurativa

作　　者：张启国[1,2] 李钟洙[1,2] 李永红[1,2] 王勉[1,2] 赵晓燕[1,2] 

机构地区：[1]厦门大学附属第一医院 [2]厦门市第一医院皮肤科,福建厦门361003

出　　处：《中国皮肤性病学杂志》2010年第8期730-732,共3页The Chinese Journal of Dermatovenereology

摘　　要：目的探讨化脓性汗腺炎的临床、组织病理特点。方法回顾性分析4例化脓性汗腺炎临床资料。结果本组病例表现为单发或多发紫红色或化脓性结节,有不同程度的疼痛和压痛,潜行性不规则溃疡,融合性斑块、脓肿及瘢痕形成等。组织病理表现为棘层肥厚,假上皮瘤样增生,真皮全层不等数量的中性粒细胞、浆细胞、淋巴细胞、组织细胞和少量嗜酸性粒细胞浸润,分布不均,典型的毛囊、汗腺等附属器罕见。部分见真皮中浅层血管内皮细胞增生、新生毛细血管及异物肉芽肿形成,毛囊周围炎和小汗腺周围炎,胶原纤维细胞增生和胶原化。4例抗酸染色和PAS染色均未查到结核杆菌和真菌。分泌物真菌和结核杆菌培养均阴性。4例均依据其临床特征、组织病理学表现、实验室检查及排除其他诊断证实。结论化脓性汗腺炎诊断需结合病史、临床表现、微生物学检查等,并排除结核及真菌感染等。应早发现早治疗,晚期病变对治疗反应不佳。Objective To study the clinical features and histopathological feature of hidradenitis suppurativa. Methods The clinical materials of 4 cases were analysed retrospectively. Results The clinical manifestations of the cases were single or multiple purple or purulent nodules, different degrees of pain and tenderness, creeping irregular ulcer, fusion of plaques, abscesses and scar formation. Histopathology showed acanthosis, pseudoepitheliomatous hyperplasia, infiltration of neutrophils, plasma cells, lymphocytes, histiocytes and a few eosinophil in dermis with uneven distribution , seen rarely in hair follicles, sweat glands and other adnexals. The vascular endothelial cell proliferation, new blood capillaries and the formation of foreign-body granuloma, inflammation around hair follicles and small glands, collagen fibers cell proliferation and collagenization in the shallow and middle parts of dermis. Both Ziehl-Neelsen staining and PAS staining were negative. Culture of fungi and tuberculosis bacillus for secretions were negative. The four cases were diagnosed according to the clinical manifestations and exclusion of other diseases. Conclusion Hidradenitis suppurativa should be found and treated early, poorly responded to treatment when developed.

关 键 词：汗腺炎 化脓性 临床特征 

分 类 号：R758.74[医药卫生—皮肤病学与性病学]