结节萎缩性皮肤淀粉样变性

A case of nodular atrophic cutaneous amyloidosis

报告1例结节萎缩性皮肤淀粉样变性。患者女,60岁。双股伸侧红褐色萎缩性斑块伴疼痛5年。皮肤科检查:双股伸侧散在分布暗红至红褐色斑块及结节,有轻度萎缩、松弛,萎缩中心局部指压时可见疝样凹陷。皮损组织病理检查:表皮萎缩变薄,真皮全层、皮下组织及血管周围有大小不一均一红染、团块状的淀粉样蛋白沉积。真皮及皮下脂肪血管周围有较多的淋巴细胞、浆细胞浸润,其间散在少许嗜酸性粒细胞。结晶紫染色阳性,PAS染色可疑阳性。诊断:结节萎缩性皮肤淀粉样变性。

A case of nodular atrophic cutaneous amyloidosis is reported.The patient was a 60-year-old woman who presented with multiple painful red-brown atrophic maeules and nodules on both her left and right thighs for 5 years. Physical examination showed multiple dark red to reddish brown plaques and nodules on the lateral side of the thigh, and were slightly atrophic and flaccid. Hernia-like sinking could be felt by pressing the centers of the lesions. Histopathologic examination revealed atrophy of the epidermis,and lumps of reddish amyloid protein of different sizes deposited in the dermis and subcutaneous tissue, and around the blood vessels. Moreover, a lot of lymphoeytes and plasma cells infiltrated around the vessels of dermis and subcutaneous fat, with a few scattered eosinophils as well. Crystal violet staining was positive and PAS staining was weakly positive. The diagnosis of nodular atrophic cutaneous amyloidosis was made.