摘要
患者男,68岁,四肢、背部、面部褐色斑疹渐增多伴偶痒20年,双下肢褐色丘疹伴瘙痒半年。皮肤科情况:四肢、背部、面部散在环形斑片,边界清楚,表面呈褐色,边缘呈角化性堤状隆起,中央轻度萎缩,压之不痛;双下肢可见圆形或椭圆形褐色粟粒大小丘疹,密集分布,质地较硬,其间可见散在圆形环状斑片。左下肢皮损组织病理示:表皮显著角化过度,棘层肥厚,真皮乳头层增宽,可见淡红着色均匀团块状物质,中有裂隙及噬色素细胞;表皮层内存在角化不全柱,下方颗粒层消失,可见角化不良细胞,真皮浅层血管周围炎症细胞浸润。结晶紫染色(+)。诊断:浅表性播散性汗孔角化症合并原发性皮肤淀粉样变。
A 68-year-old male presented with brown macules over his limbs,back and face,which gradually increased with occasional itching for 20 years,and brown papules on his lower limbs with itching for half a year.Dermatological examination revealed scattered annular patches on his limbs,back and face,with clear boundaries and brown surface,as well as keratinized embankment-like bulge at the edges,mild atrophy in the center,and no tenderness.Round or oval brown miliary papules could be seen over lower limbs,with great density and hard texture,and scattered circular annular patches in between.Pathology of skin lesions of left lower limb showed marked hyperkeratosis of the epidermis,acanthosis,widening of the papillary dermis,pale red-colored homogeneous mass with fissures and chromophages.There was a column of dyskeratosis in the epidermal layer,the lower granular layer disappeared,and dyskeratotic cells and perivascular inflammatory cells infiltrated in the superficial dermis.Crystal violet staining was positive.The diagnosis of superficial disseminated porokeratosis with primary cutaneous amyloidosis was made.
作者
郭晨琪
刘栋
林鹏
张健烽
张宇
GUO Chenqi;LIU Dong;LIN Peng;ZHANG Jianfeng;ZHANG Yu(Graduate School of Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Department of Dermatology,Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine,Tianjin Institute of Integrative Dermatology,Tianjin 300120,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2022年第9期1076-1078,共3页
The Chinese Journal of Dermatovenereology
基金
天津市卫生健康委员会中医药重点领域科研项目(2019002)。
