除草剂(硝·烟·莠去津)诱发毛发红糠疹样皮疹  

Pityriasis rubra pilaris-like eruption induced by herbicide containing atrazine,mesotrione and nicosulfuron

作　　者：宁昕 晋红中 曾跃平 NING Xin;JIN Hongzhong;ZENG Yueping(Department of Dermatology,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,National Clinical Research Center for Dermatologic and Immunologic Diseases,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院皮肤科,疑难重症及罕见病国家重点实验室,国家皮肤与免疫疾病临床医学研究中心,北京100730

出　　处：《临床皮肤科杂志》2024年第5期287-290,共4页Journal of Clinical Dermatology

基　　金：中央高水平医院临床科研业务费(2022-PUMCHB-092);中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-059);国家自然科学基金面上项目(82073450)资助项目。

摘　　要：患者女,51岁。因全身红斑、脱屑伴瘙痒2个月就诊。患者接触除草剂(硝·烟·莠去津)后头面部出现肿胀性红斑,逐渐向下发展累及躯干和四肢,表现为弥漫性红斑,表面覆有细小鳞屑,局部可见正常皮岛,伴有掌跖部皮肤角化和毛发脱落,自觉全身瘙痒、燥热。头皮组织病理检查:表皮角化过度和角化不全呈“棋盘样”交替出现,棘层增厚,皮突增宽延长。真皮浅层血管周围见较多淋巴细胞为主的炎症浸润,可见部分浆细胞。诊断:毛发红糠疹样皮疹。治疗:予口服阿维A(30 mg/d),头皮外用卡泊三醇搽剂治疗,治疗1个月后皮损完全消退。A 51-year-old female presented with scaly itching erythematous patches all over her body for 2 months.The patient developed edematous erythema on the face and scalp after using a herbicide containing 18%atrazine.The lesions expanded to her trunk and extremities gradually,which presented as diffuse erythema with overlying scales,“islands of sparing”among affected areas,palmoplantar hyperkeratosis,hair loss,and sensation of itching and burning.Histopathological examination of a skin biopsy from the scalp showed hyperkeratosis and parakeratosis alternating in both vertical and horizontal directions,acanthosis,broadening of epidermal rete ridges,perivascular infiltrate of lymphocytes and some plasma cells in the superficial dermis.A diagnosis of pityriasis rubra pilaris-like eruption was established.The patient was treated with oral acitretin30 mg per day and calcipotriol liniment for scaly patches on the scalp.The patient got a complete remission 1 month later.

关 键 词：毛发红糠疹样皮疹 除草剂 莠去津 

分 类 号：R758.6[医药卫生—皮肤病学与性病学]