结节性脂膜炎78例临床分析

Clinical Analysis of 78 Cases of Nodular Panniculitis

总结了78例经病理证实的脂膜炎患者的临床资料。本病多发生在中青年女性,分皮肤型和系统型,主要的临床表现有发热(70.51%)、关节痛(66.67%)、皮下浸润性伴有自觉痛及触痛的结节或斑块(100%)。系统型病人可伴有呼吸、循环、消化系统脏器受累及实验室检查改变。对其诊断名称、病因、早期诊断、易误诊疾病的鉴别诊断等进行了探讨。认为此病临床上并非罕见,可因其临床表现多样化不被认识而误诊,因而临床上对中青年女性、不明原因发热伴非游走性关节疼痛、皮下出现伴有自觉痛及触痛的浸润性结节或斑块应高度警惕脂膜炎的可能,须早期行病理检查。

Clinical data of 78 patients with nodular panniculitis confirmed by histopathology are reported in this article. The patients were mostly young and middle aged women. The disease was classified into two types: cutaneous type and systemic type. Main symptoms were fever (70.5%), joint pain (66.67%), subcutaneous infiltrated nodules or plaques with pain and tenderness (100%). Patients with systemic type were all associated with respiratoty, circulatory, digestive system involvment and positive laboratory examinations. The nomenclature, etiology, early diagnosis, and differential diagnosis with easily misdiagnosed diseases were discussed. It is our opinion that young and middle aged female patients suffering from fever with unknown cause, migrating joint pain, subcutaneous nodules or plaques with pain and tenderness should be highly suspected of panniculitis, and biopsies be taken early for histopathologic examination.