持久性隆起性红斑8例临床及组织病理特点分析  

Clinical and Pathological Analysis of 8 Cases with Erythema Elevatum Diutinum

作　　者：陈雪琴 王春又 宋志强 游弋 CHEN Xueqin;WANG Chunyou;SONG Zhiqiang;YOU Yi(Department of Dermatology,the First Hospital Affiliated to Army Medical University(Southwest Hospital),Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院(西南医院)皮肤科,重庆400038

出　　处：《中国皮肤性病学杂志》2023年第2期180-185,共6页The Chinese Journal of Dermatovenereology

基　　金：国家自然科学基金(82273532);重庆市自然科学基金(ctsc2017jcyjAX0251)。

摘　　要：目的探讨持久性隆起性红斑(erythema elevatum diutinum,EED)的临床特征及病理特点。方法回顾性分析2011年2月-2021年4月在本院皮肤科收治的8例EED患者的临床及病理资料。结果临床上8例患者均表现为四肢伸侧丘疹、结节或斑块,其中2例合并有红斑、水疱或脓疱。伴发疾病包括原发性胆汁性胆管炎、浆细胞性骨髓炎、类风湿关节炎、间质性肺炎、肺结核、前列腺结核、隐性梅毒、前列腺癌、急性肾损伤、高血压、糖尿病等。皮损组织病理:红斑、水疱处表现为白细胞碎裂性血管炎,斑块、结节性皮损处主要为真皮全层血管壁纤维素样变性,真皮内毛细血管及胶原纤维增生。结论氨苯砜治疗早期EED病变最有效,同时需注意EED合并系统疾病的诊治及随访。Objective To investigate the clinical features and pathological features of erythema elevatum diutinum(EED).Methods The clinical data of 8 patients with EED hospitalized in Dermatology Department of Southwest Hospital from February 2011 to April 2021 were analyzed retrospectively.Results All the 8 patients presented as papules, nodules or plaques;two of them showed erythema, blisters or pustules.Comorbid conditions in EED patients included primary biliary cholangitis, plasma cell osteomyelitis, rheumatoid arthritis, interstitial pneumonia, tuberculosis, prostatic tuberculosis, cryptic syphilis, prostate cancer, acute kidney injury, hypertension, diabetes, etc.The skin histopathology of erythema and blister is mainly characterized by leukocytoclastic vasculitis. The plaque and nodular lesions showed fibrinoid degeneration of blood vessel wall, the proliferation of capillaries and collagen fibers in the dermis.Conclusion Dapsone is the most effective treatment for early EED. At the same time, we should pay intense attention to the diagnosis, treatment and follow-up of EED complicated with systemic diseases.

关 键 词：持久性隆起性红斑 白细胞碎裂性血管炎 氨苯砜 

分 类 号：R556.5[医药卫生—血液循环系统疾病] R758.61[医药卫生—内科学]