误诊为面部体癣的嗜酸性脓疱性毛囊炎1例  

A case of eosinophilic pustular folliculitis misdiagnosed as tinea facialis

作　　者：郭倩娜 郑秀芬 王瑞华 陈春梅 汤红峰 胡勇 GUO Qianna;ZHENG Xiufen;WANG Ruihua;CHEN Chunmei;TANG Hongfeng;Hu Yong(Graduate School of Southern Medical University,Guangzhou 528308,China)

机构地区：[1]南方医科大学研究生院,广州510515 [2]南方医科大学顺德医院皮肤科

出　　处：《实用皮肤病学杂志》2024年第3期190-192,共3页Journal of Practical Dermatology

基　　金：广东省中医药局科研项目(20211380)。

摘　　要：21岁男性患者,面部反复出现红斑、脓疱伴瘙痒6个月。皮肤科情况:面部可见融合的大片红斑,中间有消退倾向,边界尚清,红斑上散在分布1~2mm大小的毛囊性红色丘疹、脓疱,无压痛。面部皮损活检组织病理示:真皮浅中层的毛囊皮脂腺、血管、汗腺周围可见大量的嗜酸粒细胞及少量的嗜中性粒细胞、淋巴细胞浸润,毛囊皮脂腺内嗜酸性微脓肿形成,小部分毛囊皮脂腺结构受破坏。诊断:嗜酸性脓疱性毛囊炎。治疗:给予醋酸泼尼松20mg每日1次口服,外用0.1%他克莫司乳膏,5d后醋酸泼尼松逐渐减量,治疗约3个月皮损基本消退。A 21-year-old malepatient presented with recurrent facial erythemaand pustules,alongwith itchingfor six months.The dermatological condition showed that the large patches of fused erythema on the face,with a distinct boundary and a tendency to fade in the center.The erythema is scattered with follicular red papules and pustules measuring 1-2 mm in size,without tenderness.The histopathological examination of facial skin biopsy showed that a significant infiltration of eosinophils,along with a minor presence of neutrophils and lymphocytes,was observed surrounding the sebaceous glands of hair follicles,blood vessels,and sweat glands in the superficial middle dermis.Eosinophilic microabscesses were formed within the sebaceous glands of hair follicles,resulting in partial destruction.The patient was diagnosed as eosinophilic pustular folliculitis.The patient received a combination therapy of oral prednisone tablets at a dosage of 20 mg per day along with topical tacrolimus.Gradual tapering of the prednisone was initiated after 5 days,leading to significant improvement in skin lesions after 3 months of treatment.

关 键 词：毛囊炎 嗜酸性 脓疱性 体癣 

分 类 号：R753.3[医药卫生—皮肤病学与性病学]