有表皮下水疱形成的急性泛发性扁平苔藓1例

One Case of Acute Widespread Lichen Planus with Subepidermal Blister

患者男,49岁。全身起紫红色丘疹和丘疱疹3月余,伴瘙痒。皮肤科情况:躯干及四肢可见泛发性紫红色扁平丘疹及丘疱疹,粟粒至黄豆大小,以腰背部及双下肢受累为著,部分融合成斑块,上附少量白色鳞屑,不易刮除,可见Wickham纹。腰部皮损组织病理示:表皮角化过度,颗粒层局灶性增厚,棘层肥厚,基底细胞严重液化变性,表皮下水疱,真皮浅层单一核细胞带状浸润。诊断:急性泛发性扁平苔藓。

A 49-years-oht man presented with 3 month history of multiple violaceous papules and papulovesicles over his trunk and limbs with itching. Physical examination showed violaceous papules and papulovesicles over his trunk and limbs widespreadly, and the size as big as grain to soybean, some forming plaques with white adherent scales. Histopathnlogy of lesion biopsy showed basal layer with a ＂saw-tooth＂ pattern of epidermal hyperplasia,orthokeratosis,beaded bypergranulosis and acanthosis. Basal cell liquefaction degener forming Max Joseph cavity and subepidermal blister,dense and bandlike infihrate composed of lymphocytes. Diagnosis was acute widespread lichen planus.