泛发性光泽苔藓并发毛发扁平苔藓  

Generalized lichen nitidus with lichen planopilaris

作　　者：姚志远[1] 董洪军[1] 白倩倩[1] 张耀文[1] 汪晨[1] 

机构地区：[1]北京中日友好医院皮肤科,北京100029

出　　处：《临床皮肤科杂志》2014年第9期550-552,共3页Journal of Clinical Dermatology

摘　　要：报告1例泛发性光泽苔藓并发毛发扁平苔藓。患儿女,4岁。头皮、颈项部、背部及四肢出现肤色丘疹4年余。皮肤科检查:头皮可见毛囊性针头大丘疹,毛发稀疏卷曲;颈项、背部及四肢可见针头大肤色坚实丘疹,有光泽。皮损组织病理检查:角化过度伴角化不全,基底细胞液化变性,真皮乳头浅层半球形浸润性细胞团块,团块两侧表皮突延长,呈典型的"抱球状"外观;同时可见毛囊上皮基底细胞液化变性,周围可见淋巴细胞为主的带状浸润。免疫组化显示浸润细胞以CD4^+细胞为主。诊断:泛发性光泽苔藓并发毛发扁平苔藓。治疗:给予他克莫司软膏,维A酸乳膏外用,转移因子口服液治疗,病情好转。A patient with generalized lichen nitidus and lichen planopilaris is reported. A four-year-old girl presented with a 4year history of skin--colored papules on her scalp, neck, back and limbs. Dermatologic examination showed that pinhead-sized follicular papules with sparse and curled hair on the scalp. There were firm skin-colored, shiny papules on her neck, back and limbs. Histopathological examination displayed the epidermal hyperkeratosis and parakeratosis with liquefaction degeneration in basal cells. There were dense hemispheric inflammatory infiltrates in the papillary dermis. This infiltrate appeared to be clutched by elongated epidermal ridges resembling a ＂ball and claw＂ pattern. There was also liquefaction degeneration of the follicular epithelial basal cells surrounded by band-like lymphocytic infiltration. Immunohistochemical staining showed that the majority of the infiltrates were CD4^＋ T lymphocytes. The patient was diagnosed as generalized lichen nitidus with lichen planopilaris according to the clinical and histopathological features. Disease was improved after treatment with tacrolimus ointment, retinoic acid cream and oral transfer factor solution.

关 键 词：光泽苔藓 毛发扁平苔藓 儿童 

分 类 号：R758.65[医药卫生—皮肤病学与性病学]