皮肤浆细胞增多症一例

A case of cutaneous plasmacytosis

24岁女性患者,腰腹部出现红褐色斑疹和斑片6个月。皮肤科情况:腰腹部散在分布直径0.5～2 cm红褐色斑疹及斑片,触诊浸润感明显。组织病理检查见皮肤内成熟浆细胞呈团块状浸润;免疫组化显示浆细胞为多克隆增殖。诊断:皮肤浆细胞增多症。治疗:口服雷公藤多苷、外用复方曲安奈德乳膏3个月效果不佳;调整治疗为醋酸泼尼松15 mg每日1次、沙利度胺50 mg每日2次口服,治疗2个月后,皮损变平,触诊浸润感减轻。

A 24-year-old female presented with red-brown macules and patches on the abdomen for 6 months. Dermatological examination showed multiple red-brown macules and patches which were 0.5~2 cm in diameter on her abdomen. Histopathological examination found collections of mature plasma cells infiltrated in the dermis. Immunohistochemistry demonstrated the infiltrated plasma cells were polyclonal. The patient was diagnosed as cutaneous plasmacytosis. The lesions had no remarkable improvement after treatment with tripterygium glycosides and triamcinolone acetonide ointment for 3 months. Then the medicines were changed to prednisone 15 mg daily, thalidomide 50 mg twice daily and 0.03% tarcrolimus ointment twice daily. After next 2 months of therapy, the lesions became flat and the infiltration decreased.