嗜酸性脂膜炎1例

患者女,29岁,左下肢出现肿胀性斑块2个月。皮肤专科检查可见左下肢小腿屈侧近腘窝处一约2.5 cm×2.0 cm的肿胀性斑块,在斑块的右侧有一约3.0 cm×2.5 cm大小皮损,淡红色,质地柔韧,有浸润感,局部温度略高,无压痛。血常规检测见嗜酸性粒细胞计数及嗜酸性粒细胞百分比轻度增高。皮损组织病理检查示表皮正常,真皮深层、皮下脂肪间隔散在较多嗜酸性粒细胞,少许淋巴细胞浸润,见巨细胞。诊断为嗜酸性脂膜炎。给予患者泼尼松片30 mg每日1次、雷公藤20 mg每日3次治疗,皮损好转,基本消退。     

嗜酸性脂膜炎1例

患者女,29岁,左下肢出现肿胀性斑块2个月。皮肤专科检查可见左下肢小腿屈侧近腘窝处一约2.5 cm×2.0 cm的肿胀性斑块,在斑块的右侧有一约3.0 cm×2.5 cm大小皮损,淡红色,质地柔韧,有浸润感,局部温度略高,无压痛。血常规检测见嗜酸性粒细胞计数及嗜酸性粒细胞百分比轻度增高。皮损组织病理检查示表皮正常,真皮深层、皮下脂肪间隔散在较多嗜酸性粒细胞,少许淋巴细胞浸润,见巨细胞。诊断为嗜酸性脂膜炎。给予患者泼尼松片30 mg每日1次、雷公藤20 mg每日3次治疗,皮损好转,基本消退。     

甲状腺乳头状癌合并嗜酸性蜂窝织炎1例

患者女,14岁。甲状腺乳头状癌次全切术后7周,双小腿红肿2周。体检:双下肢可见大片水肿性红斑,界限不清,触诊有浸润感,无压痛,皮温高。外周血嗜酸性粒细胞计数升高。皮损组织病理示:表皮灶性海绵水肿,真皮浅层水肿,真皮全层可见血管周围及胶原束间多数嗜酸性粒细胞浸润,血管周围见中等密度组织细胞、淋巴细胞浸润。诊断:嗜酸性蜂窝织炎。     

嗜酸性筋膜炎1例

患者男,22岁。四肢皮肤水肿、硬化1年。查血嗜酸粒细胞340×106/L;ANA1:40(+)。皮损组织病理:真皮血管周围少量淋巴细胞及组织细胞浸润,皮下脂肪可见片状淋巴细胞、较多嗜酸性粒细胞。诊断为嗜酸性筋膜炎。给予强的松、西米替丁、青霉胺口服并联合物理疗法,取得满意效果。     

环状肉芽肿样儿童Sweet综合征1例

患者男,8岁。面、背部及左上肢红斑、丘疹和斑块2周。皮肤科情况:面部可见暗紫红色丘疹;左上肢、背部可见暗紫红色斑块,呈环状,边界清楚,似环状肉芽肿样,有轻度触痛。左上肢皮损组织病理示:角化过度,棘层增厚,真皮乳头水肿,真皮内弥漫性中性粒细胞、嗜酸性粒细胞、淋巴细胞浸润,可见核尘。诊断为:Sweet综合征。     

细菌性皮肤病

20111167呈带状损害的嗜酸性蜂窝织炎1例/张江安(郑大一附院皮科),于建斌,苗青…∥中国皮肤性病学杂志.-2010,24(12).-1140～1141转1162患者男,62岁。左背部见一带状斑块,质韧。外周血和骨髓嗜酸性粒细胞增多。皮损组织病理示真皮胶原间、真皮血管和附属器周围见致密淋巴细胞和嗜酸性粒细胞     

嗜酸性脓疱性毛囊炎1例

患者男,22岁。面部红斑、丘疹和脓疱,伴脱屑3月余。面部可见数个红色或暗红色斑块和丘疹,顶部可见针尖大脓疱,伴破溃。血常规正常。皮损组织病理示:表皮角化过度、棘层轻度增厚。毛囊及真皮内可见大量以嗜酸性粒细胞为主的炎性细胞浸润,毛囊内见嗜酸性脓肿。     

嗜酸性蜂窝织炎1例

报道1例嗜酸性蜂窝织炎。患者男，19岁：双侧下肢先后出现红斑3年，红斑持续发展，无明显不适。组织病理检查示真皮全层及皮下组织可见大量嗜酸性粒细胞．可见“火焰征”及外周嗜酸性粒细胞包绕的肉芽肿样结构，以皮下脂肪明显、血常规示嗜酸性粒细胞绝对值5．2×10^9／L。予泼尼松30mg/d，病情缓解：     

嗜酸性脓疱性毛囊炎

报告1例嗜酸性脓疱性毛囊炎.患者男,20岁.躯干、四肢出现毛囊性丘疹、脱屑1个月.皮肤科检查颈部、躯干及四肢弥漫红色及暗红色斑片,其上密集分布粟粒大毛囊性丘疹,部分丘疹顶端可见针尖大脓疱.血常规及骨髓检查均示嗜酸性粒细胞增多.皮损组织病理检查示表皮角化过度,棘细胞层不规则增厚,毛囊及真皮内有大量以嗜酸性粒细胞为主的炎性细胞浸润,可见毛囊内嗜酸性粒细胞小脓肿.     

播散性嗜酸性细胞胶原病1例

患者,女,33岁,全身红斑、丘疹,脱屑伴瘙痒反复20余年,关节痛、畸形10余年,间断性发热2年。血常规提示白细胞总数升高显著,嗜酸性粒细胞计数大于1.5×109/L超过6个月。皮肤组织病理:真皮浅、中层血管周围及胶原间嗜酸性粒细胞浸润,有真皮胶原增粗及血管内皮细胞肿胀。诊断:播散性嗜酸性细胞胶原病。     

特发于手掌部的嗜酸性脓疱性毛囊炎1例

患者男,19岁。左手掌反复出现水疱、脓疱伴瘙痒2月余。体检:左手掌见多处淡红色轻度脱屑性斑疹、斑片,伴有小水疱、脓疱及结痂,右手掌散在多个水疱。外周血和骨髓中嗜酸性粒细胞增多。左手掌皮损组织病理检查示:真皮及皮下组织中大量以嗜酸粒细胞为主的炎细胞浸润。诊断:嗜酸性脓疱性毛囊炎。口服强的松30mg/d后皮损迅速消退。     

上皮样血管瘤1例

报告1例发生于头部的上皮样血管瘤。患者男，40岁。左侧头皮多发性丘疹、结节7年组织病理检查示：病变由许多增生的大小不等的血管组成，血管内皮细胞较肥大，呈立方形或上皮样突向腔内形成鞋钉状，血管间散在灶性炎性细胞浸润，以淋巴细胞为主，可见少量嗜酸粒细胞，病理诊断为上皮样血管瘤。     

A case of cutaneous T cell lymphoma treated with recombinant interleukin 2 (rIL-2)

We report a case of cutaneous T cell lymphoma (CTCL) treated with local injection of recombinant interleukin 2 (rIL-2). The biopsy specimen showed marked infiltration of large convoluted cells admixed with small lymphocytes and histiocytes in the epidermis, dermis and subcutis. After six injections of rIL-2, 4 nodules out of 5 on the left lower leg disappeared and the remaining large nodule was diminished in size. A biopsy specimen from the diminished nodule showed infiltration of small lymphocytes with histiocytes and plasma cells in the dermis. The atypical cells, large hyperconvoluted lymphocytes, had disappeared. A large number (28%) of lysozyme- and alpha 1-anti-chymotrypsin-positive cells were demonstrated by immunohistochemistry. The patient maintained complete remission for a period of 13 months. He then noticed a small red nodule on the back of the left foot, which was histologically confirmed as a recurrence. Chemotherapy cleared the lesion.     

Regression of papular elastolytic giant cell granuloma using narrow-band UVB irradiation

A 71-year-old Japanese man presented with asymptomatic, firm, brown-red papules on the dorsum of his left hand and back. A biopsy specimen revealed granulomatous infiltration consisting of multinucleated giant cells and histiocytes in the upper dermis. Elastic fibers were absent in the upper dermis, having been phagocytosed by giant cells. These papular elastolytic giant cell granuloma lesions regressed very well with narrow-band ul traviolet B irradiation, with only residual brown pigmentation left after treatment.     

Eosinophilic Panniculitis Following the Subcutaneous Injection of Exenatide Extended-Release

Exenatide extended-release was recently developed as an antidiabetic drug; it acts as a glucagon-like peptide-1 receptor agonist. A 54-year-old male visited our clinic complaining of a subcutaneous tender nodule on his left thigh that had developed over the course of 1 week. The patient had received exenatide extended-release injections for 5 months to treat diabetes. A histopathologic examination showed septal and lobular panniculitis with lymphohistiocyte and eosinophil infiltration. The patient was diagnosed with eosinophilic panniculitis (EP) due to exenatide extended-release injection. EP is a rare type of panniculitis characterized by a prominent infiltrate of eosinophils in the subcutaneous fat layer. It is a histologic reaction pattern that is associated with various clinical conditions. Among the injection-site reactions reported in exenatide extended-release users, injection-site nodules occur infrequently. Clinicians who treat diabetics who use exenatide extended-release should be aware of the possible occurrence of injection-site nodules.     

虫咬后嗜酸性蜂窝织炎一例

患者,男,24岁。因左手背虫咬后出现水肿性红斑4个月就诊。皮损组织活检示真皮大量嗜酸性粒细胞浸润,呈现“火焰征”。诊断:嗜酸性蜂窝织炎。给予口服抗组胺药、外用糖皮质激素治疗。     

Erythema gyratum repens responding to cetirizine hydrochloride

We report a case of erythema gyratum repens (EGR) in a 59-year-old man with inoperable pancreatic cancer and liver metastasis. The patient had a widespread erythema with concentric marginal band spreading in waves over the trunk and extremities. Numerous vesicles were seen on the margin of the erythema. The skin lesions were severely pruritic, and his peripheral blood showed marked eosinophilia. He also had palmoplantar hyperkeratosis. A biopsy specimen of the erythema disclosed spongiosis, microvesicles filled with eosinophils, infiltration of eosinophils into the epidermis, and a perivascular infiltrate in the dermis. The skin lesions and pruritus cleared quickly after the administration of cetirizine hydrochloride.     

Kimura's disease

A 40-year-old white Caucasian man presented with a 6-month history of a 1.5 × 1.5 cm nodular lesion on his left arm. No history of trauma preceeded the lesion and the patient was in good general health.
Dermatologic examination revealed a solitary, red, painless nodule located on the left arm (Fig. 1). Histopathologic examination of punch biopsy revealed lymphoid follicles, some of which had active germinal centers in the deep dermis and subcutaneous tissue. Mixed infiltration of lymphocytes, plasma cells and many eosinophils were present in the interfollicular region. Infiltration of the germinal centers by eosinophils, causing partial destruction, was observed (Fig. 2A). There was also proliferation of thin-walled small vessels and fibrosis in some parts of the interfollicular areas (Fig. 2B). Although Kimura's disease (KD) and angiolymphoid hyperplasia with eosinophilia (ALHE) were considered in the differential diagnosis, it was diagnosed as KD based on these histologic features. Further laboratory examinations were performed. Serum IgE was normal and peripheral eosinophilia was absent.
The lesion regressed after biopsy. Complete healing was achieved with intralesional corticosteroid (triamcinolone acetonide) treatment.     

Churg-Strauss syndrome involving medium-sized arteries

A 69-year-old Japanese man suffered from bronchial asthma, atrial fibrillation, general fatigue, high fever, and weight loss of about 5 kg within a month. He also had intermittent claudication, a tingling feeling in his fingers and toes, and an ulcer on his toe. His laboratory data revealed leukocytosis with absolute eosinophilia. The patient was treated with predonisolone 30 mg daily. Although the ulcers healed once, the lesions recurred with tapering predonisolone. The patient visited us because of the ulcer on his toe. Physical examination showed a 2 cm ulcer surrounded by slight erythema on his right fourth toe. Magnetic resonance angiography detected tapering stenosis of the medium-sized arteries in both legs. A biopsy from his myocardium showed the infiltration of eosinophils into the myocardium. The neuron conduction rate of his lower leg was slower than that of the normal control, demonstrating mononeuritis. From these findings, we diagnosed this patient as Churg-Strauss syndrome.     

网状组织细胞肉芽肿

报告1例网状组织细胞肉芽肿。患者男,35岁。左侧面部淡红色丘疹2个月。皮损组织病理检查示真皮上部可见形状不规则的组织细胞、多核巨细胞、淋巴细胞,以及少量嗜酸性粒细胞和中性粒细胞。组织细胞和多核巨细胞的胞质内含有染色较淡、均匀一致的嗜伊红细颗粒状物质,使胞质呈“毛玻璃”样外观。组织病理诊断：网状组织细胞肉芽肿。