系统性硬皮病并发皮肤结节病

A case of systemic scleroderma with skin sarcoidosis

患者女,54岁。发现四肢皮下结节1个月,系统性硬皮病病史20余年。皮肤科检查见"假面具脸",双手呈鹰爪样改变,四肢串珠状排列和散在分布大小不等的皮下结节,边界清楚,质硬,活动不明显,皮肤表观正常。皮损组织病理:皮下脂肪间隔多数结核样结构,大部分呈"裸结节",未见典型干酪样坏死,周围淋巴细胞很少。诊断:系统性硬皮病并发皮肤结节病。

A 54-year-old woman suffered from systemic scleroderma for over 20 years and subcutaneous nodules in the limbs for one month. Dermatological examination showed ＂face mask＂ and the eagle claw-like hands. Fixed subcutaneous nodules var- ied in sizes and were arranged in bead-string-like or scattered on the limbs, with demarcated borders and firm texture. The skin surface appeared normal. Skin histopatbology showed TB-like structure in adipose septum with some hard tubercles and lymphocytic infiltration, no typical caseous necrosis. Diagnosis： syetemic scleroderma with skin sarcoidosis.