大疱性蕈样肉芽肿

Mycosis fungoides bullosa: a case report

报告1例大疱性蕈样肉芽肿。患者男,40岁。因躯干、四肢红斑伴瘙痒6年,出现斑块半年、水疱1个月就诊。皮肤科检查:面部、躯干及四肢泛发红斑和斑块,部分斑块浸润明显。右下腹斑块上可见0.5cm×2cm的水疱。皮损组织病理检查:真皮浅层明显水肿,部分区域可见表皮下疱形成,真皮浅层可见异形明显的单一核细胞呈带状浸润。部分单一核细胞侵入表皮,形成Pautrier微脓肿。免疫组化染色结果示LCA(++++)、CD4(++++)、CD45RO(++++)。结合临床、免疫组化和组织病理检查结果,诊断为大疱性蕈样肉芽肿。

A case of mycosis fungoides bullosa is reported. A 40-year-old man presented with erythemas over the trunk and limbs for 6 years, with plaques for half a year, and vesicle for 1 month. Physical examination revealed diffuse erythemas on the face, trunk and limbs, dozens of plaques on some erythemas and a vesicles on the lesion of the abdomen. Biopsy of the plaque lesion showed bandlike infiltration of atypical lymphocytes in the upper dermis, epidermotropism, Pautrier＇s microab- seesses in the epidermis and subepidermal bullae. Immunohistochemieal stain found the infiltrated lymphocytes were positive to LCA （＋＋＋＋）, CD4 （＋＋＋＋） and CD45RO （＋＋＋＋）. The patient was diagnosed as mycosis fungoides bullosa.