手背嗜中性皮病1例

A Case of Neutrophilic Dermatosis of the Dorsal Hands

患者男，58岁。左手背红斑伴疼痛2周。皮肤科情况：左手背多发水肿性红斑，直径1-4cm不等，部分透亮呈假性水疱样，无脓疱、溃疡、出血等，触痛明显。皮损组织病理检查示：中性粒细胞外移入表皮，真皮乳头轻度水肿，真皮浅中层见大量中性粒细胞、淋巴细胞等浸润，可见局灶性轻度核尘。血管壁未见纤维素样改变。治疗上予泼尼松10mg，3次/d，口服治疗，1个月之内皮损完全消退。诊断为手背嗜中性皮病。

A 5g-year-old man presented with a painful erythema on the left dorsal hand for 2 weeks. Skin examination revealed multiple edematous erythema ranging from 1 - 4cm in diameter. There was typical presentation of pseudovesicular lesions with tenderness, but no pustules, ulcerations or bleeding. Biopsy demonstrated that neutrophils presented the epidermis. Mild edema was seen in the papillary dermis. There were noticeable infiltration of the neutrophlic cells and lymphocytes, as well as focal nucleus dusts. The wall of blood vessel was normal. Treatment with prednison 10mg three times daily resulted in complete resolution of the lesions in 1 month. The clinical presentation, the histological features, and the excellent response to oral corticosteroid therapy allowed us to classify this case as neutrophilic dermatosis of the dorsal hands.