痒疹样血管瘤5例临床及病理分析国内首报  

Clinical and pathological characteristics of five cases of prurigiform angiomatosis first reported in China

作　　者：王斐艳 徐明圆 吴南辉 吴飞[2] 刘业强[2] WANG Feiyan;XU Mingyuan;WU Nanhui;WU Fei;LIU Yeqiang(Department of Dermatologic Surgery,Shanghai Shin Disease Hospital/Skin Disease Hospital of Tongji University,Shanghai 200071,China;Department of Pathology,Shanghai Shkin Disease Hospital/Shin Disease Hospital of Tongji University,Shanghai 200071,China)

机构地区：[1]上海市皮肤病医院/同济大学附属皮肤病医院皮肤外二科,上海200071 [2]上海市皮肤病医院/同济大学附属皮肤病医院病理科,上海200071

出　　处：《临床皮肤科杂志》2025年第3期133-136,共4页Journal of Clinical Dermatology

基　　金：上海市科委自然科学基金项目(23ZR1456100,22ZR1455500)。

摘　　要：目的:分析痒疹样血管瘤的临床及组织病理特点。方法:回顾分析5例痒疹样血管瘤患者的临床、组织病理和免疫组化特点。结果:5例痒疹样血管瘤的临床表现为单发或多发的暗红色斑块,形态各异,境界较清,表面苔藓化,上覆鳞屑和(或)痂皮,一般无明显自觉症状。镜下均表现慢性单纯性苔藓和(或)结节性痒疹的表皮特征,即角化过度伴局灶性角化不全、棘层不规则增厚、表皮突下延;真皮浅层均有小血管增生,呈带状排列,与获得性弹性组织变性血管瘤非常相似。免疫组化示CD34在血管壁表达(+)、D2-40在淋巴管壁表达(+)、平滑肌肌动蛋白(SMA)(±)。结论:痒疹样血管瘤是一种独特的临床及组织病理变异的非肿瘤性血管病变,但其病因仍富有争议,推测可能与慢性压力或重复机械刺激有关。Objective: To analyze the clinical and pathological characteristics of prurigiform angiomatosis. Methods: A retrospective analysis was conducted on the clinical, histopathological, and immunohistochemical features of five patients diagnosed with prurigiform angiomatosis. Results: The clinical features of prurigiform angiomatosis included solitary or multiple dark red plaques of varying shapes, with relatively well-defined borders, lichenification, and covered by scales and/or crusts. No significant subjective symptoms were reported. Histologically, all samples exhibited chronic simple lichenification and/or nodular prurigo in the epidermis, characteristic of hyperkeratosis with focal parakeratosis, irregular acanthosis, and downward extension of rete ridges. Small vessels in the superficial dermis increased and were arranged in a band-like pattern, resembling acquired elastotic hemangioma. Immunohistochemistry showed positive expression of CD34 in the vascular walls, positive expression of D2-40 in the lymphatic vessel walls, and variable expression of smooth muscle actin(SMA). Conclusion: Prurigiform angiomatosis is a non-neoplastic vascular lesion with distinct clinical and pathological variations. However, its origin remains controversial, and may associate with chronic stress or repeated mechanical stimulation.

关 键 词：痒疹样血管瘤 获得性弹性组织变性血管瘤 痒疹 

分 类 号：R739.5[医药卫生—肿瘤]