长期误诊的肉芽肿性皮肤松弛症一例

A long-term misdiagnosed case of granulomatous slack skin

报告1例伴皮肤慢性溃疡而长期误诊的肉芽肿性皮肤松弛症。患者男，40岁。左臀部皮下肿块及溃疡5年伴疼痛，皱褶部位皮肤松弛1年。皮肤科检查：左臀部弥漫性暗红色斑块，其上多个大小不一的深在性溃疡，皱褶部位皮肤松弛明显。组织病理检查：单个核细胞移入表皮，真皮全层可见淋巴细胞、组织细胞弥漫性浸润，可见多核巨细胞。免疫组化示淋巴细胞CD3、CD43、CD45RO均阳性，CD20和CD79α阴性；多核巨细胞CD68阳性。

A long-term misdiagnosed case of granulomatous slack skin complicated by chronic cutaneous ulcer is reported. A 40-year-old male patient presented with a 5-year-history subcutaneous mass and painful ulcers on the left buttock, as well as 1-year-history slack skin on skin folds. Dermatological examination showed diffuse dark erythematous plaques on the left buttock, with irregularly sized deep ulcers on their surface. Slack skin was obvious on skin folds. Histopathological examination revealed mononuclear cells migrating into the epidermis, diffuse dermal infiltration of lymphocytes and histocytes with the presence of multinuelear giant cells. Immunohistochemistry demonstrated that these lymphocytes were positive for CD3, CD43, CD45RO, but negative for CD20 or CD79α, and muhinuclear giant ceils were positive for CD68.