持久性隆起性红斑9例临床病理分析

Clinicopathologic analysis of 9 patients with erythema elevatum diutinum

回顾性分析9例持久性隆起红斑患者的临床资料。临床表现为丘疹、结节或斑块8例;红斑、水疱或脓疱3例。合并疾病包括多发性骨髓瘤、类风湿性关节炎和边缘性溃疡性角膜炎。实验室检查的显著特点是血清IgA水平升高,部分患者出现单克隆M蛋白。患者皮肤组织病理检查均见到核尘。结节性皮损累及真皮全层,主要表现为内皮细胞肿胀和增生;红斑或丘疹病变累及真皮浅中层,主要表现为血管壁明显纤维素样坏死。

The data of 9 patents with erythema elevatum diutinum （ EED） were analyzed retrospectively. The main clinical features included nodules or plaques in 8 patients, erythema, blister and pustules in 3 pa-tients. The associated diseases included multiple myeloma, rheumatoid arthritis and peripheral ulcerative kera-titis. The distinct feature of laboratory test was the high level of serum IgA and the monoclonal gammopathies in some patients. Histopathology showed that there was nuclear dust in all lesions. The lesions of nodule extend to the whole dermis and the feature was the proliferation of endothelial cells. The lesions of plaques extend to the superficial and medial layer and the feature was the fibrinoid necrosis of vessel wall.