儿童组织样麻风瘤1例

A Case of Histoid Lepromain in Child

患儿女,12岁。四肢丘疹、结节、斑块6个月。患者既往无麻风接触史。皮肤科情况:四肢见粟米至绿豆大小肤色或淡红褐色丘疹、小结节,左肘关节屈侧、左小腿分别见一3cm×4cm,1cm×2cm大小红褐色斑块,左手背见多个黄豆至鹅蛋大小红褐色不规则斑块,境界清楚。未见丘疱疹、水疱,眉毛无脱落,皮损处痛温觉减退或局部消失。皮损组织病理示:表皮萎缩,表皮下见一无浸润带。真皮内见结节状或大片状梭形或多角形组织样细胞浸润,并见稀疏淋巴细胞分布。抗酸染色可见大量抗酸杆菌(4+)。诊断:组织样麻风瘤。

A 12-year-old female presented with 6-month history of papules,nodules and plaques on her upper and lower limbs. She had no history of contact with leprosy patients. On examination, both upper and lower limbs showed ,nultiple skin or reddish brown colored, maize to green bean sized papules, nodules. A reddish brown patch sized 3cm ×4cm presented on the flexure of left elbow,and 1cm ×2cm on the left leg. There were multiple, soybean to goose egg sized, well-demarcated, irregular red-brown plaques on her left dorsal hand. Patient nev- er had papulovesicles,blisters,loss of eyebrows,or loss of sensation. Histopathologic examination demonstrated atrophic epidermis and clear zone below the epidermis whereas dermis had large nodular or patchy infiltration of fusiform or polygonal histiocytes with scattered lymphocytes. Acid-fast staining showed a large number of acid-fast bacilli（4 ＋ ）. Patient was diagnosed as histoid leproma.