血清EBV-IgG阳性的持久性多形红斑1例

Persistent Erythema Multiforme with Serum Positive EBV-IgG: A Case Report

患者男,28岁。双侧手、小腿及足踝部反复起黄豆大至钱币大小红斑3年,偶有瘙痒。皮疹常有反复,保持发作-消退-再发作模式,周而复始。系统检查无异常。皮肤科情况:双侧手、小腿及足踝部散在数十个暗红色水肿性红斑,圆形或椭圆形,边界清晰,部分中央有紫红色斑或水疱,呈典型靶形损害,并可见炎症后色素沉着斑。皮损组织病理示:表皮角质形成细胞灶状坏死,表皮下水疱形成,真皮浅层血管周围单一核细胞浸润。EBV-DNA原位杂交阴性。血清EBV-IgG阳性,EBV病毒载量2.3×103。诊断:持久性多形红斑。

A 28-year-old male presented with a 3-year history of persistent erythematous lesions on both hands, legs and ankles. The rashes followed the pattern of “onset- fadeaway -onset again”. The systemic examination found no abnormity. Physical examination revealed scattered round or oval erythematous lesions on both hands, legs and ankles, with dark-red edematous patches or blisters in the center of the lesions, showing typical target lesions. Histopathological findings revealed epidermal keratinocytes necrosis, subepidermal blister formation and perivascular mononuclear cell infiltration in the superficial dermis. EBV-DNA in situ hybridization was negative while serum EBV-IgG was positive, and EBV viral load was 2. 3 - 103. Diagnosis of persistent ery- thema muhiforme was made.