蕈样肉芽肿治疗后发生多发性真皮纤维瘤一例  

Multiple eruptive dermatofibromas following treatment of granuloma fungoides： a case report

作　　者：李百周[1] 陈琴[1] 陈积愫[1] 王平[1] 

机构地区：[1]浙江大学医学院附属第二医院,杭州310009

出　　处：《中华皮肤科杂志》2014年第2期124-125,共2页Chinese Journal of Dermatology

基　　金：浙江省自然科学基金（Y2110367）

摘　　要：患者女，45岁，全身粟粒样丘疹15年，伴瘙痒和皮肤极度干燥。6年前逐渐出现毛发脱落和腋下、腹股沟、双乳间皮肤松弛，诊断为肉芽肿性松弛性皮肤伴亲毛囊性蕈样肉芽肿。予以6个疗程环磷酰胺 ＋ 多柔比星 ＋ 长春新碱 ＋ 泼尼松（CHOP）方案全身化疗，在确诊前后均长期口服泼尼松（30 ~ 40 mg/d）治疗。近半年来双腿、前胸和背部出现10余个皮肤隆起性结节，切取背部一个活检。组织病理学检查见真皮下境界清楚的结节状病灶，无包膜，细胞梭形和卵圆形排列成席纹样，有少量巨细胞，无明显异形性，符合典型的真皮纤维瘤特征。诊断：多发性真皮纤维瘤。目前在随访中。A 45-year-old female was admitted to the hospital for a 15-year history of miliary papules all over the body surface with severe skin dryness and pruritus. Six years prior to the presentation, she suffered from gradual loss of head, axillary and pubic hair as well as skin laxity in the axillary, inguinal and intermammary region, and diagnosed with granulomatous slack skin associated with folliculotropic granuloma fungoides. Then, she received six sessions of chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone （CHOP）. Additionally, long-term oral prednisone （30 - 40 mg per day） was administrated before and after the diagnosis. Half a year prior to the presentation, more than 10 elevated nodules gradually appeared in bilateral lower limbs, chest and back. Pathology of one of the nodules revealed a well-defined nodular lesion without capsules in the subdermis, composed of spindle and oval cells arranged in a storiform pattern as well as a small number of giant cells without obvious atypia, which was suggestive of dermatofibroma. The final diagnosis was multiple eruptive dermatofibromas. The patient was managed with a watch-and-wait strategy, and follow-up was under way.

关 键 词：蕈样肉芽肿 纤维瘤 真皮 泼尼松 

分 类 号：R739.5[医药卫生—肿瘤]