丘疹坏死性结核疹并瘰疬性皮肤结核1例  

A Case of Papulonecrotic Tuberculid with Scrofuloderma

作　　者：杜丹[1] 蒋献[1] 薛丽[1] 张敏[1] 

机构地区：[1]四川大学华西医院皮肤性病科,四川成都610041

出　　处：《中国皮肤性病学杂志》2016年第5期506-507,536,共3页The Chinese Journal of Dermatovenereology

摘　　要：患者女,20岁。四肢丘疹、丘脓疱疹、溃疡5年,颈部结节、溃疡、瘢痕6个月。相关实验室检查包括结核PPD试验(强阳性),γ-干扰素释放试验(阳性),结核荧光定量PCR(可疑阳性)。颈部皮损组织病理示:表皮轻度肥厚,真皮内大片干酪样坏死,可见散在上皮样肉芽肿及较多淋巴细胞、少量浆细胞浸润。小腿皮损组织病理示:表皮呈银屑病样增生,真皮及皮下脂肪浅层小血管周围较多淋巴细胞,少量嗜酸性粒细胞浸润。诊断:丘疹坏死性结核疹并瘰疬性皮肤结核。A 20-year-old girl presented with papules, papulopustules and ulcers on her limbs for five years and developed with nodule, ulcer and scar on her right neck for half a year. Relevant laboratory tests showed skin tuberculin test（ strong positive）, interferon-γ release assays （positive）and TB fluorescence quantitative PC R （ questionable positive）. The histological examination of skin lesion on her neck revealed epidermal acanthosis, and caseation necrosis, sporadic epithelioid granulomas, abundant lymphocytes and a little plasmocytes in the dermis. Histological examination of skin lession on her shank showed psoriasiform hyperplasia in the epidermis, perivascular infiltration of many lymphocytes and a little eosinophils in the dermis and the superficial subcutaneous fat. The diagnosis of papulonecrotic tuberculid with scrofuloderma was made.

关 键 词：丘疹 坏死性 结核疹 结核 皮肤 瘰疬性 

分 类 号：R529.4[医药卫生—内科学]