白色萎缩误诊为变应性血管炎1例

A Case of Atrophie Blanche Misdiagnosed as Allergic Cutaneus Vascllitis

患者女,18岁。双下肢瘀点、水疱、坏死伴瘙痒和疼痛4年,加重1个月。皮肤科情况:双下肢瘀点、水疱、散在分布黑色痂皮、黄白色萎缩性瘢痕,双足背网状紫色斑。皮损组织病理示:真皮血管增生,部分血管壁增厚、纤维素样变性及血管腔闭塞,血管周围淋巴细胞、组织细胞浸润。免疫荧光检查C3:血管壁(3+),基底膜线性荧光(+);IgM,IgA和IgG均(-)。诊断:白色萎缩。

A 18-year-old female presented with petechiae, blister and necrosis on his limbs four years before, and whose conditions were aggravated by one month. The clinical manifestations was the lower limbs with petechiae, blister, necrosis and the feeling of itch and painful, scattered by black scab and whtie and yellow atrophic scar on the skin, double foot back with mesh purple spot. Histopathological examnation of the skin lesion revealed the leather vascular proliferation, Part of the blood vessel wall thickening, cellulose sample degenera- tion and Vessel lumen occlusipn, perivascular lymphocytes and histiocytes infiltrates. Immunofluorescence result showed that C3 of the vascular wall is 3 ＋, the basement membrane linear fluorescent is 1 ＋, and the IgM, IgA, IgG were negative. Atrophie blanche was diagnosed based on clinical and histopathologyical features.