多次误诊的恶性萎缩性丘疹病1例  

A Case of Malignant Atrophic Papulosis Misdiagnosed Repeatedly

作　　者：刘家秀 赵维佳[1] 李玉叶[1] LIU Jiaxiu;ZHAO Weijia;LI Yuye(Department of Dermatology and Venereology,the First Affiliated Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学第一附属医院皮肤性病科,云南昆明650000

出　　处：《中国皮肤性病学杂志》2021年第9期1021-1023,1058,共4页The Chinese Journal of Dermatovenereology

基　　金：云南省“万人计划”名医专项;云南省卫生和计划生育委员会医学领军人才(L-201613);云南省皮肤免疫疾病临床医学研究中心(2019ZF012);云南省皮肤免疫性疾病临床医学中心(ZX2019-03-02)。

摘　　要：患者男,56岁,全身散在丘疹、萎缩性瘢痕1年余。皮疹起初为粟粒至黄豆大小的丘疹,表面泛白,无脓点、破溃、糜烂,后丘疹中央逐渐出现萎缩,边缘隆起伴轻度水肿,最终形成瘢痕,表面附着薄层鳞屑。皮损组织病理示:表皮灶性坏死、结痂、变薄,基底层细胞液化变性,真皮浅层楔形胶原硬化,部分血管梗塞、坏死。诊断:恶性萎缩性丘疹病。患者经双嘧达莫、沙利度胺、灯盏生脉胶囊口服治疗,未见明显好转。A 56-year-old male presented with scattered papules and atrophic scars all over the body for more than one year.The rash was initially a papule with the size of a miliary to a soybean.The surface was white with no pus,ulceration,or erosion.The center of the papule gradually shrinked,the edge was raised with mild edema,and finally a scar was formed with a thin layer of scale attached to the surface.Pathology of the skin lesion showed epidermal focal necrosis,scab,thinning,liquefaction and degeneration of basal cells,sclerosis of wedge-shaped collagen in the superficial dermis,and partial vascular infarction and necrosis.Diagnosis of malignant atrophic papulosis was made.Oral treatment of dipyridamole,thalidomide,and Dengzhan Shengmai capsules did not contribute to any significant improvement.

关 键 词：恶性萎缩性丘疹病 德戈斯病 灶性坏死 血管梗塞 误诊 

分 类 号：R758.6[医药卫生—皮肤病学与性病学]