播散性盘状红斑狼疮并发皮肤淀粉样变性

Disseminated discoid lupus erythematosus complicated with cutaneous amyloidosis:a case report

报告1例播散性盘状红斑狼疮并发皮肤淀粉样变性。患者女,54岁。头皮、面部、耳后、上臂和背部出现暗红色丘疹、斑块26年。皮肤科检查:头皮、面部、耳后、双上臂和背部见多个暗红色丘疹及斑块,部分皮损上覆银白色粘着性鳞屑,头顶部见一大片状类圆形暗红色斑,中央头发脱落。实验室检查:血沉、血清球蛋白、IgG升高,补体C3降低,抗核抗体阳性。皮损组织病理改变符合盘状红斑狼疮和皮肤淀粉样变性;此外,真皮乳头和浅层见无定形、均质状、嗜酸性团块,甲紫染色呈紫红色,刚果红染色阳性,PAS染色也为阳性。诊断:播散性盘状红斑狼疮并发皮肤淀粉样变性。在诊断盘状红斑狼疮时,应同时注意是否并发皮肤淀粉样变性。

A case of disseminated discoid lupus erythematosus with cutaneous amyloidosis is reported. A 54-year-old female presented with dark red papules and plaques on the scalp, face, posterior aures, upper arms and back for 26 years. Physical examination revealed multiple dark red papules and plaques on the scalp, face, posterior aures, upper arms and back, covered by silvery white, adherent scales on some lesions. There was a large, oval, dark red patch on the top of the scalp, with hair loss in the center of it. The laboratory tests showed increased ESR, serum globulins and imnmnoglobulin G, decreased serum complement C3, and positive ANA. The histopathological changes of the lesion were consistent with discoid lupus erythematosus and cutaneous amyloidosis. The homogeneous, eosinophilic masses deposited in the papillary dermis were seen, positively stained for methyl violet, Congo red and PAS. The diagnosis is disseminated discoid lupus erythematosus concomitant with cutaneous amyloidosis. When a diagnosis of discoid lupus erythematosus is made, we should be cautious if it is accompanied by cutaneous amyloidosis.