18例皮肤结节红斑患者的临床与病理分析

The analysis on chinical and pathological features of 18 patients with skin-nodular-erythema

目的探讨皮肤结节红斑患者的病因、临床特点、病理及治疗。方法回顾性分析2006～2008年间我科收住以皮肤结节红斑损害为特征的18例患者的临床及病理资料并进行随访。结果男2例,女16例,病程4天～6年;结节性血管炎3例;特发性结节性脂膜炎3例;结节性红斑12例,其中原发5例,继发7例(5例感染,其中结核感染3例、乙肝1例、链球菌感染1例,2例自身免疫性疾病,分别为白塞病、混合性结缔组织病)。组织病理学检查显示以单纯间隔性脂膜炎为主,部分呈小叶性和混合性脂膜炎,并伴有血管炎表现。随访中4例患者复发。结论结节红斑可以是多种疾病的临床表现,应常规检查有无链球菌、乙肝病毒及结核菌感染,重视免疫和病理学检查。积极治疗原发病,依据病情及时加用甲氨喋呤或糖皮质激素。

Objective To investigate the etiology, clinical features, pathology and treatment of patients with skin - nodular - erythema. Methods 18 patients whose skin damage was characterized by nodular erythema, those were at Yijishan Hospital of Wannan medical colleage from 2006 to 2008 were retrospective analysed and followed - up studied. Results There were 2 men and 16 women, ranging in course from 4 days to 6 years. 3 patients were diagnosed as nodular vasculitis, 3 were idiopathic nodular panniculitis, 12 were erythema no- dosum, in which five cases were primary, 7 were secondary [5 cases of infection, of which 3 cases of TB infection, 1 of hepatitis B virus, 1 of streptococcus, 2 cases of autoimmune disease （Behcet＇s disease and mixed connective tissue disease）]. The histopathological examination showed that most cases were simple intervalic panniculitis mainly, part of them were lobular and mixed panniculitis with the performance of vasculitis. All patients were followed, and 4 of them recurred. Conclusion Nodular - erytbema could be associated with a variety of diseases. labortory examinations should be tested including Infection of streptococcus, hepatitis B virus and tuberculosis should be tested routinely, and immune and pathological examination should be paid more attention to. Any primary diseases should be treated actively, and methotrexate and glucocorticoids should be used in time according to the patients＇ condition.