腹部离心性脂肪营养不良15例临床表现及组织病理分析  

Clinical manifestations and histopathological analysis of 15 cases of lipodystrophia centrifugalis abdominalis

作　　者：梁锦开 陈凤鸣 王雷 LIANG Jinkai;CHEN Fengming;WANG Lei(Cadet Team 6 of School of Basic Medicine,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学基础医学院学员六大队,西安710032 [2]空军军医大学西京医院皮肤科(西京皮肤医院)

出　　处：《实用皮肤病学杂志》2024年第4期207-210,共4页Journal of Practical Dermatology

摘　　要：目的观察腹部离心性脂肪营养不良的临床表现及组织病理特征。方法对2015年1月至2023年12月空军军医大学西京医院皮肤科确诊的15例腹部离心性脂肪营养不良患者的临床及组织病理资料进行回顾性分析。结果15例患者中男8例,女7例。发病年龄1个月~8岁,其中9例发生于4岁以前。15例患者中12例累及腹部,11例累及腹股沟,4例累及腰部,1例累及腋窝及季肋部。15例临床表现为局部皮肤萎缩,14例皮肤表面有扩张的血管,11例萎缩区周围可见红斑。组织病理变化可分为2种特征,有7份标本取自于皮损中央萎缩区,表现为皮下脂肪的萎缩或未见明确皮下脂肪组织;10份标本取自于皮损周围红斑,表现为小叶性脂膜炎,浸润细胞主要为淋巴细胞和组织细胞。12例患者有随访结果,皮损均已停止发展,但萎缩区尚未恢复正常。结论腹部离心性脂肪营养不良多见于4岁以下的婴幼儿,好发于腹部及腹股沟,临床表现具有一定的特征性,组织病理表现为脂肪萎缩或小叶性脂膜炎。Objective To invesitgate the clinical and histopathological features of lipodystrophia centrifugalis abdominalis(LCA).Methods The clinical and histopathological data of 15 cases diagnosed with LCA in the department of dermatology of Xijing Hospital from January 2015 to December 2023 were retrospectively analyzed.Results The 15 LCA cases consisted of 8 males and 7 females.The age of onset ranged from one month to eight years,with nine cases occurring prior to the age of 4 years.LCA predominantly occurred predominantly on the abdomen(12 cases),followed by the groin(11 cases),lumbar region(4 cases),axilla and hypochondriac region(1 case).All cases presented with atrophic skin patchs,with the dilated blood vessels on the skin surface in 14 cases and the slightly erythematous border in 11cases.The histological examination revealed the presence of two distinct patterns.Seven biopsies taken from the central depressed area of the lesions revealed a significant reduction or complete absence of subcutaneous fat.Ten biopsies taken from the peripheral erythema showed a lobular panniculitis consisting of lymphocytes and histiocytes.Follow-up data was available in 12 cases,and the lesions remained stable with no signs of atrophy recovery in all cases.Conclusions The occurrence of LCA primarily affects infants and children under the age of4,predominantly in the abdominal and groin regions.The clinical manifestations of LCA exhibit distinct characteristics and histopathology showed subcutaneous tissue absence and lobular panniculitis.

关 键 词：脂肪营养不良 临床表现 组织病理 

分 类 号：R758.69[医药卫生—皮肤病学与性病学]