22例狼疮性脂膜炎临床和病理分析

Lupus Erythematosus Panniculitis:Clinical and Histopathological Analysis of 22 Cases

目的探讨狼疮性脂膜炎的临床和病理表现、治疗经验及预后特点。方法回顾性分析北京协和医院皮肤科2008年1月至2010年2月收治的22例狼疮性脂膜炎患者的临床、组织病理特点及治疗预后情况。结果皮损好发于头面部、上肢及臀部,常表现为皮肤萎缩、红斑、皮下结节、浸润性红斑及皮肤破溃。病理的典型改变为皮下脂肪层出现淋巴细胞浸润为主的小叶性脂膜炎,也可同时出现脂肪小叶间隔性脂膜炎。治疗以硫酸羟氯喹单用或合用激素为主,大多数患者对治疗反应较好,部分患者出现反复。结论狼疮性脂膜炎较少见,其典型的临床和病理特征是其诊断的要点,硫酸羟氯喹及中小剂量糖皮质激素治疗有效。

Objective To explore the clinical and histopatholigical manifestations,therapy and prognosis of lupus erythematosus panniculitis（LEP）.Method We retrospectively reviewed the clinical data and hitopathological features of 22 cases of LEP diagnosed at Peking Union Medical College Hospital from January 2008 to February 2010.Results The lesions appeared as atrophy,erythema,subcutaneous nodules,infiltrated erythema,and ulceration over the scalp,face,upper limbs,and buttock.Histopathological features were lobular panniculitis in the subcutaneous fat;sometimes septal panniculitis could be seen.Hydroxychloroquine sulfate and corticosteroid were effective treatment;most patients responded well to the treatment,while a few experienced recurrence when the treatment tapped or discontinued.Conclusions LEP is a rare cutaneous variant of lupus erythematosus.The diagnosis of LEP is mainly based on clinical findings and pathological features.Hydroxychloroquine and low-and middle-dose corticoseroid are effective for the treatment of LEP.