坏死松解性肢端红斑一例  

A case of necrolytic acral erythema

作　　者：储开宇[1] 莫惠芳[1] 王键旋[1] 毛荣军[2] Chu Kaiyu;Mo Huifang;Wang Jianxuan;Mao Rongjun(Department of Dermatology,Foshan Hospital of TCM,Foshan 528000,Guangdong,China;Department of Pathology,Foshan Hospital of TCM,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市中医院皮肤科,广东528000 [2]佛山市中医院病理科,广东528000

出　　处：《中华皮肤科杂志》2019年第9期604-606,共3页Chinese Journal of Dermatology

摘　　要：患者女,25岁,双足部皮疹伴瘙痒10年。皮肤科情况:双足趾背及邻近足背、右踝伸侧、左跟腱可见边界清楚的暗红色斑块,上覆灰褐色鳞屑。实验室检查:血清丙型肝炎抗体阴性,丙型肝炎病毒核酸定量正常。右侧足背皮损组织病理:表皮角化过度伴角化不全,棘层不规则增生,棘层中上部散在角化不良细胞和坏死角质形成细胞,基底细胞局灶性液化变性;真皮浅中层小血管扩张,周围少量淋巴细胞浸润。诊断:不伴丙型肝炎的坏死松解性肢端红斑。治疗2个月后皮疹完全消退,遗留色素沉着。A 25-year-old female patient presented with itchy rashes on her feet for 10 years. Skin examination showed dark red plaques with clear boundaries, whose surfaces were covered with grey-brown scales, on the dorsum of toes and adjacent dorsum of the feet, the extensor aspect of the right ankle and the left Achilles tendon. Laboratory tests revealed that serum anti-hepatitis C virus (HCV) antibody was negative and HCV-RNA quantity was normal. Histopathological examination showed epidermal hyperkeratosis with parakeratosis, irregularly thickened spinous layer, scattered dyskeratotic cells and necrotic keratinocytes in the middle and upper spinous layer, focal liquefaction degeneration of basal cells, dilatation of small blood vessels in the superficial and middle dermis, and perivascular infiltration of a small number of lymphocytes. The patient was diagnosed with necrolytic acral erythema without hepatitis C. After 2-month treatment, the skin lesions completely regressed, and hyperpigmentation remained.

关 键 词：丙型肝炎 松解坏死型游走性红斑 坏死松解性肢端红斑 

分 类 号：R758.61[医药卫生—皮肤病学与性病学]