Malignant atrophic papulosis:Two case reports  

作　　者：Zhi-Gui Li Jia-Ming Zhou Li Li Xiao-Dong Wang 

机构地区：[1]Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China [2]Department of Clinical Medicine,West China School of Medicine,Sichuan University,Chengdu 610207,Sichuan Province,China

出　　处：《World Journal of Clinical Cases》2022年第35期12971-12979,共9页世界临床病例杂志

基　　金：Key Project of Science and Technology Department of Sichuan Province,No.2022YFS0337.

摘　　要：BACKGROUND Malignant atrophic papulosis is a rare and potentially lethal thrombo-occlusive microvasculopathy characterized by cutaneous papules and gastrointestinal perforation.The precise pathogenesis of this disease remains obscure.CASE SUMMARY We describe the case of a 67-year-old male patient who initially presented with cutaneous aubergine papules and dull pain in the epigastrium.One week after symptom onset,he was admitted to the hospital for worsening abdominal pain.Exploratory laparotomy showed patchy necrosis and subserosal white plaque lesions on the small intestinal wall,along with multiple perforations.Histological examination of the small intestine showed extensive hyperemia,edema,necrosis with varying degrees of inflammatory reactions in the small bowel wall,small vasculitis with fibrinoid necrosis and intraluminal thrombosis in the mesothelium.Based on the mentioned evidence,a diagnosis of malignant atrophic papulosis was made.We also present the case of a 46-year-old man with known cutaneous manifestations,abdominal pain,nausea and vomiting.His physical examination showed positive rebound tenderness.A computed tomography scan revealed free intraperitoneal air.He required surgical intervention on admission and then developed an esophageal perforation.He ultimately died of a massive hemorrhage.CONCLUSION In previously published cases of this disease,the cutaneous lesions initially appeared as small erythematous papules.Subsequently,the papules became porcelain-white atrophic depression lesions with a pink,telangiectatic peripheral rim.In one of the patients,the cutaneous lesions appeared as aubergine papules.The other patient developed multiple perforations in the gastrointestinal tract.Due to malignant atrophic papulosis affecting multiple organs,many authors speculated that it is not a specific entity.This case series serves as additional evidence for our hypothesis.

关 键 词：Malignant atrophic papulosis Gastrointestinal perforation PAPULOSIS Thrombo-occlusive microvasculopathy Case report 

分 类 号：R597[医药卫生—内科学]