肉芽肿性皮肤松弛症

A case of granulomatous slack skin

报告1例肉芽肿性皮肤松弛症。患者女,46岁。双侧腹股沟红斑、条索状肿块伴疼痛1年。皮肤科检查:双侧腹股沟浸润性红斑,左侧腹股沟可触及4 cm×10 cm条索状质硬肿块,表面皮肤松弛。皮损组织病理检查:真皮内大量淋巴样细胞浸润,可见淋巴细胞亲表皮现象,真皮内可见散在多核巨细胞。免疫病理示淋巴样细胞CD2、CD5及CD4均阳性;多核巨细胞CD68/PGM-1阳性。弹性纤维染色可见部分区域弹性纤维减少。TCR-γ基因重排示克隆性扩增峰。诊断:肉芽肿性皮肤松弛症。

A case of granulomatous slack skin is reported. A 46-year-old female presented with painful skin lesion in the bilateral inguinal region for 1 year. Dermatological examination showed infiltrated erythematous plaque in the bilateral inguinal region. A hard subcutaneous mass sized 4 cm× 10 cm could be touched in the left inguinal region. Slack skin was present on the skin lesion. Histopathological examination revealed dense lymphoid infiltration and scattered multinuclear giant cells in the dermis. Epidermotropism was also observed. The lymphoid cells were positive for CD2, CD5, CD4, and the multinuclear giant cells were positive for CD68/PGM-1. Decreased elastic fibers appeared in some regions. T-cell receptor（TCR）-γ gene rear- rangement showed an amplification peak. The diagnosis of granulomatous slack skin was made.