毛囊闭锁三联征  

A case of follicular occlusion triad

作　　者：张向东 张珍珍 赵琳[1] 张选奋[1] ZHANG Xiang-dong;ZHANG Zhen-zhen;ZHAO Lin;ZHANG Xuan-fen(Department of Plmtic surgery,Lanzhou Unwersity Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院整形外科,甘肃兰州730000

出　　处：《临床皮肤科杂志》2020年第12期743-746,共4页Journal of Clinical Dermatology

摘　　要：患者男,63岁。头面部、躯干、臀部及会阴部多发结节、囊肿、窦道及瘢痕30余年,会阴部皮损反复流脓血4个月余。皮肤科检查:头部多发结节及瘢痕性秃发,面部、胸背部及臀部多处大小不等的点状凹陷性瘢痕及窦道,会阴部一黄豆大囊肿,表面破溃,呈火山口状,上覆鳞屑及脓性分泌物。皮损组织病理:表皮角化过度,伴角化不全,可见多个毛囊角质栓,有微脓肿及结痂形成,棘层增生肥厚,表皮突增生延长,基底层黑素增多,真皮层纤维组织增生,毛囊扩张明显,囊腔内充满角化物及脓性渗出物,毛囊周围伴大量中性粒细胞、淋巴细胞浸润,可见多核巨细胞,部分扩张的毛囊内含多根毳毛。诊断:毛囊闭锁三联征。治疗:行会阴部肿物切除术及皮瓣覆盖术。A case of follicular occlusion triad is reported.A 63-year-old man presented with multiple,nodules,cysts,sinus tracts,and scars on the head,face,trunk,hips,and perineum for more than 30 years.A progressive mass in perineum ruptured repeatedly and oozed pus and blood for more than 4 months.Dermatological examination showed multiple nodules and cicatricial alopecia on the head,multiple point-like depressed scars and sinus tracts of various sizes on the face,chest,back and buttocks,a large soybean cyst in the perineum with a ruptured surface and a volcanic crater shape,overlying scales and purulent discharge.Histopathological examination revealed hyperkeratosis of the epidermis,accompanied by incomplete keratinization,mul tiple keratinous plugs in hair follicles,microabscesses and crusting formation,Stratum spinosum hyperplasia and hypertrophy,prolonged epidermal hyperplasia,increased melanin in the basal layer,and Hyperplasia of fibrous tissue in the dermis,hair follicle expansion was obvious,the cyst cavity was filled with keratinous and purulent exudate.There were a large number of neutrophils and lymphocyte infiltration around the hair follicle.Multinucleated giant cells could be seen.Part of the expanded hair follicle contained more vellus hair.The diagnosis of follicular occlusion triad was made.Perineal mass resection and flap covering surgery was performed.

关 键 词：毛囊闭锁三联征 手术治疗 皮瓣覆盖术 

分 类 号：R758.73[医药卫生—皮肤病学与性病学]