肉芽肿性口周皮炎二例

Granulomatous perioral dermatitis：two case reports

报告2例肉芽肿性口周皮炎。例1男，6岁。面部红斑、丘疹5个月就诊。曾外用糖皮质激素软膏后皮疹渐增多。例2女，28岁。口周、鼻周红斑、小丘疹2个月余就诊。2例均表现为面部腔口周围直径1—3mm大小的淡红色坚实小丘疹，皮损组织病理检查：真皮毛囊周围上皮样细胞肉芽肿改变。结合临床表现及组织病理学检查，2例均确诊为肉芽肿性口周皮炎。例1口服琥乙红霉素颗粒200mg/次，每日4次、1％克林霉素凝胶和0．03％他克莫司软膏外用，治疗2个月后皮疹完全消退，1个月后口周皮疹又复发。例2在行组织病理活检后皮疹自行消退，提示本病具有临床自愈倾向。

Two cases of granulomatous perioral dermatitis are reported. A 6-year-old boy presented with erythema and papules on the face for 5 months, which had been exacerbated after application of topical glucocorticoids. The other patient was a 28-yeax-old woman, who presented with erythema and papules around the mouth and nose for more than 2 months. Small pink indurated papules measuring 1 to 3 mm in diameter were observed in the periorificial region of both patients. Histopathologic examination of the lesions showed granulomatous changes of epithelioid cells around the follicles in dermis. Both cases were diagnosed as granulomatous perioral dermatitis based on the clinical manifestation and histopathological findings. The lesions in patient 1 completely subsided after 2 months of treatment with oral erythromycin 200 mg 4 times daily as well as topical clindamycin 1% gel and tacrolimus 0.03% ointment, but recurred one month later. The other patient experienced a spontaneous regression of lesions, which hinted a trend to spontaneous cure of this entity.