线状皮肤型红斑狼疮一例

A case of linear cutaneous lupus erythematosus

男性47岁患者,下颏及颈部线状紫褐色斑2个月。查体见下颏及颈前正中线偏右侧处有一0.5~1.0 cm宽,15 cm长的线状紫褐色斑片,线状皮损的部分区域有轻度萎缩,无明显凹陷,无明显浸润感。皮损组织病理示表皮轻度角化过度伴毛囊角栓形成,灶性表皮萎缩,基底细胞液化变性,真皮内血管及毛囊周围大量单一核细胞浸润。直接免疫荧光示:基膜带IgG或IgM呈断续短线状和颗粒状沉积,真皮浅层IgG和IgM呈颗粒状或团块状沉积(荧光强度+^++),C3在真皮乳头呈颗粒状沉积。最终确诊为线状皮肤型红斑狼疮。

A 47-year-old male presented with two-month history of linear purple brown spot on the chin and neck. Physical examination showed that there was a linear purple brown patche located on the right side of the chin and the midline of the anterior neck, which was about 0.5-1.0 cm wide and 15 cm long. There was slight atrophy in some areas of the linear lesions, without obvious depression and infiltration. Histopathologieal findings revealed mild hyperkeratosis, local epidermal atrophy, follicular plugs, basal epidermis and hair follicle degeneration, pigment incontinence and dense lymphocytic infiltration around dermal blood vessels and hair follicles. Direct immunofluorescence showed intermittent linear and granular deposition of lgG or lgM along the basemenl membrane, superficial dermal lgG and lgM granular or lump deposition （fluorescence intensity ＋ - ＋ ＋）, C3 granular deposition in the dermal papilla. The patient eventually diagnosed as linear cutaneous lupus erythematosus.