环状肉芽肿4例误诊分析

Misdiagnosis Analysis of Four Cases with Granuloma Annulare

例1男,8岁。躯干、下肢环状红斑6个月。皮损表现为躯干、下肢散在淡红色、肤色环状斑片,边界清楚,中央色素沉着斑,曾误诊为"湿疹"、"色素性荨麻疹"。例2男,47岁。面颈部丘疹伴痒2个月。皮损主要为面颈部肤色光泽丘疹,部分中央有脐凹,曾误诊为"结节病"、"巨大型传染性软疣"。例3女,64岁。面颈手臂丘疹、环状红斑1年。皮损为颈部、前胸、两上肢大小不等丘疹、环状红斑,红斑边缘隆起,中央稍凹陷,曾误诊为"急性发热性嗜中性皮病"、"扁平苔藓"、"离心性环状红斑"。例4女,68岁。手臂、颈肩部斑块1年余。主要皮损为面部、颈肩部、两手臂环状、不规则形的暗红色斑块,境界较清,边缘隆起。曾误诊为"离心性环状红斑"、"泛发性体癣"。4例患者均依据临床表现和组织病理特征及其他实验室检查诊断为环状肉芽肿。

Case 1 was an eight-year old boy, presented with scattered annular erythema on the trunk and legs for 6 months. Physical examination showed light red or skin colored annular patches with clear boundary and central hyperpigmentation. He was misdiagnosed with eczema and urticaria pigmentosa. Case 2 was a 47-year old male, presented with pruritic papules on the face and neck for 2 months. Physical examination showed skin colored shining papules, some of which were in umbilicated appearance, on the face and neck. He was misdiagnosed with sarcoidosis and huge molluscum contagiosum. Case 3 was a 64-year old female, presented with papules and annular erythema in different size on the face and arms for 12 months. Physical examination showed skin colored shining papules with clear boundary and sunken center on the face, neck, trunk and arms. She was misdiagnosed with Sweet＇s syndrome, lichen planus and erythema annulare centrifugum. And case 4 was a 68-year old female, presented with plaques on the neck, shoulder and arms for over 12 months. Physical examination showed annular or irregular dark red plaques with clear elevated boundary on the face, neck, shoulder and arms. She was misdiagnosed with erythema annulare centrifugum and generalized tinea corporis. Based on the clinical and pathological findings, and other laboratory examinations, the diagnosis of granuloma annular was made in these four cases.