表现为环状损害的阴囊多发性硬下疳1例

A Case of Syphilis with Multi-chancres

患者男,25岁。阴囊多发性环状红斑2周。查体见阴囊30多处环形红斑,边缘隆起,表面湿润,少量渗液。实验室检查:TPPA(+),RPR(1:64),HIV抗体(-)。皮损组织病理:局部皮肤溃疡,表皮有缺损,皮下肉芽组织增生,浆细胞和中性粒细胞浸润,并伴较多的嗜酸性粒细胞。诊断:多发性硬下疳。予苄星青霉素240万U分两侧臀部肌注,1次/周,连用3次后皮损消退。

A 65-year-old man presented with plaques all over the body for 6 years with erosion and exudates for 2 years.Physical examination showed erythematous plaques of all sizes on the face,neck,upper trunk,upper and lower limbs,in the intertigious,and anus,accompanied by erosion,exudates,and crusts.Skin biopsy and histopathology showed the epidermis revealed erosion and hyperplasia with mild spongiosis.A crumb mass of lymphocytes and a small amount of eosinophilic granulocytes were seen in the dermis.Part of lymphocytes showed epidermotropism. Immunohistochemistry demonstrated positive for CD3,CD4,CD8,negative for CD20,CD30,CD79a,and Ki-67 presented a level proliferation index of 30%～40%. A diagnosis of mycosis fungoides was made.