炎症性肠病伴皮肤表现的临床与病理分析  

Clinical and pathological analyses of two cases of inflammatory bowel disease with cutaneous manifestations

作　　者：丘晓英 夏传刚 肖文[2] 陈方如[1] QIU Xiaoying;XIA Chuangang;XIAO Wen;CHEN Fangru(Affiliated Hospital of Guilin Medical College,Guilin 541001,China;Liuzhou Workers′Hospital,Liuzhou 545005,China)

机构地区：[1]桂林医学院附属医院,广西桂林541001 [2]柳州市工人医院,广西柳州545005

出　　处：《皮肤性病诊疗学杂志》2024年第8期518-523,共6页Journal of Diagnosis and Therapy on Dermato-venereology

基　　金：桂林市卫生健康委医美康养人才小高地建设项目;柳州市科技计划项目(2022CAC0227);广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20170846)。

摘　　要：目的 分析炎症性肠病(IBD)皮肤表现的临床及组织病理特点,为临床诊断提供指导。方法 回顾性分析2例IBD伴皮肤表现的临床及病理特点。结果 1例患者为克罗恩病合并皮肤表现,皮损表现为肛周红斑、溃疡,组织病理表现为真皮非干酪样非感染性肉芽肿,使用乌司奴单抗治疗后溃疡面积缩小。另1例为溃疡性结肠炎合并肠外表现,皮损表现为全身红斑、结节,小腿、臀部可见溃疡,组织病理表现为真皮中性粒细胞浸润,使用英夫利昔单抗治疗后皮损部分消退。结论 IBD合并皮肤表现具有不同的组织病理学特点。诊断时临床医生需结合临床表现及组织病理以免误诊漏诊。Objective To analyze the clinical and histopathological features of skin manifestations of inflammatory bowel disease(IBD)in order to provide guidance for clinical diagnosis.Methods Clinical and pathological characteristics of 2 patients with IBD were retrospectively analyzed.Results One patient had Crohn′s disease manifested by perianal erythema and ulcers,and histopathology showed non-caseous and non-infectious granuloma in the dermis.Treatment with Ustekinumab decreased the ulcerative area.In another case of ulcerative colitis with extraintestinal manifestations,erythemas and nodules were all over the body,and ulcers were on the lower legs and buttocks.Histopathology showed dermal neutrophil infiltration.The skin lesions partially subsided after the treatment with Infliximab.Conclusions IBD with cutaneous manifestations has different histopathological characteristics,and clinicians should make the diagnosis based on both clinical manifestations and histopathological features in order to avoid misdiagnosis and missed diagnosis.

关 键 词：炎症性肠病 克罗恩病 溃疡性结肠炎 皮肤表现 病理特点 

分 类 号：R574[医药卫生—消化系统]