厚皮指症2例  

Pachydermodactyly: a report of 2 cases

作　　者：吴瑕[1] 窦侠[1] 邵勇[1] 黄海艳[1] 于波[1] 

机构地区：[1]北京大学深圳医院皮肤科,广东深圳518036

出　　处：《临床皮肤科杂志》2016年第7期513-515,共3页Journal of Clinical Dermatology

摘　　要：报告2例厚皮指症。例1．男，27岁。双手近端指节梭形肿胀半年。皮肤科检查：双手第2～5指近端指节两侧呈明显梭形肿胀，皮肤粗糙、增厚，未扪及皮下包块。例2．男，17岁。双手指近端指间（PIP）关节梭形肿胀2年余。皮肤科检查：双手指PIP关节周围呈明显梭形肿胀，以右手为重，皮肤粗糙、增厚。2例患者既往体健，均有反复挤压双手指间关节史。2例患者双手x线检查均示受累部位周围软组织肿胀，未见骨及关节异常。2例患者皮损组织病理改变均表现为表皮轻度增厚．板层状角化过度，棘层肥厚；真皮层明显增厚，真皮胶原纤维增生，排列不规则，真皮浅层毛细血管周围见少量淋巴细胞和浆细胞浸润。诊断均为厚皮指症。治疗：例1患者因病程短，无明显自觉症状，未予治疗，活检术后2周诉肿胀好转。例2患者确诊后嘱停止挤压关节，未予治疗．随访6个月病情无明显变化。Two cases of pachydermodactyly are reported. Case 1. A 27-year-old male presented with half year history of fusiform swelling in the proximal phalanxes of both hands, Physical examination revealed swelling, thickening and rough in the proximal phalanxes of the second to fifth fingers on both hands with no subcutaneous lump. Case 2. A 17-year-old boy presented with 2-year history of swelling in the proximal interphalangeal （PIP） joints of both hands. Physical examination showed swelling, thickening and rough in the PIP joints of both hands, but more severe on the right hand. Both patients were otherwise healthy except having a habit of cracking their knuckles. X-ray of bilateral hands of both patients revealed soft tissue swelling in the involved fingers. The interphalangeal and metaearpophalangeal joints appeared normal. Histopatho- logical examination of both patients revealed epidermal hyperplasia with hyperkeratosis and acanthosis, marked thickening of the dermis, hyperproliferation and irregular arrangement of collagenous fibers in dermis, and a mild perivaseular infiltration of lymphocytes and plasma cells in the upper dermis. The diagnosis of pachydermodactyly was made for both. Because of the short course and asymptom, the case 1 received no treatment. The swelling of his fingers improved two weeks after biopsies. The other patient was advised to stop cracking knuckles and no changes were observed during six months of follow-up.

关 键 词：厚皮指症 指间关节 近端 指节 近端 

分 类 号：R758.1[医药卫生—皮肤病学与性病学]