迟发性皮肤卟啉病一例

A case of porphyria cutanea tarda

男性61岁患者,因头颈部、双上肢红斑和丘疹7+年,加重伴水疱2周就诊。日晒后瘙痒加重。皮肤科检查:头颈部密集分布大小不等的红斑、丘疹,大部分红斑肥厚,部分红斑上可见黄豆大小窦道,窦道可挤出白色豆渣样分泌物,红斑间散在结节、囊肿;双上肢散在红斑、丘疹,右手可见数个水疱。皮损组织病理示:表皮角化过度,表皮下水疱,真皮浅层小血管周围稀疏淋巴细胞浸润。尿总卟啉1 599.90μg/24 h,24 h尿液Wood灯照射检查下呈珊瑚红色。诊断:迟发性皮肤卟啉病。治疗:复方甘草酸苷注射液40 ml、多烯磷脂酰胆碱注射液20 ml每日1次静脉滴注,硫酸羟氯喹片100 mg每周2次口服,10 d后,患者水疱消退,无新发皮损,随访半年病情无复发。

A 61-year-old male patient was referred to our clinic due to erythema and papules on head, neck and upper limbs for more than 7 years, and a two weeks history of aggravation with blisters formation Sun exposure could aggravate the patient＇s Wood＇s light examination all supported the glycyrrhizin intravenous injection and oral