硬化萎缩性苔藓合并局限性硬皮病一例

A ease of lichen sclerosus et atrophicus with localized scleroderma

患者男，44岁。躯干、四肢皮肤泛发硬化萎缩斑片进行性加重8年，自觉瘙痒。检查见皮损有色素沉着和色素减退，触之有皮革样硬度。口腔黏膜、肛门、外生殖器未见皮损，不伴系统损害，常规实验室检查无异常发现。组织病理显示，表皮角化过度，萎缩变薄，基底细胞液化变性，真皮乳头层见纯一化变性带。真皮中下层胶原纤维增生、致密、红染，轻度玻璃样变。诊断为硬化萎缩性苔藓合并局限性硬皮病。

A 44-year-old man was admitted to the hospital for generalized sclerotic and atrophic patches with itching on the trunk and extremities, which had exacerbated progressively for 8 years. Physical examination revealed hyperpigmentation and hypopigmentation in lesions with leather-like stiffness. No lesions were found in oral mucosa or anogenital area, and no systemic involvement or abnormity was found in routine laboratory examination. Histopathological examination showed hyperkeratosis, atrophy and thinning of epidermis, liquifaction degeneration of basal cells, as well as a band-like homogeneous degeneration in papillary layer of dermis. Proliferated, dense, and gently hyalinized collagen fibers strongly positive for eosin were observed in medium and lower dermis. The case was diagnosed as lichen sclerosus et atrophicus with localized scleroderma.