慢性苔藓样角化病

Keratosis lichenoides chronica:a case report

报告1例慢性苔藓样角化病。患者女,20岁。面部、躯干及四肢紫红色丘疹和斑块约20年。皮肤科检查:面部、躯干及四肢可见紫红色丘疹和斑块,皮损相互融合呈网状及线状,部分为毛囊性丘疹,皮损表面覆少量灰白色鳞屑,伴轻度瘙痒。Auspitz征阴性。未见口腔溃疡、眼损害及甲损害等。皮损组织病理检查:表皮角化过度伴角化不全,棘层不规则肥厚,基底层色素增加,灶状基底层变性,可见胶样小体;真皮浅层可见由淋巴细胞及组织细胞为主的带状浸润。诊断:慢性苔藓样角化病。予口服阿维A治疗6个月后皮损变平。

A case of keratosis lichennoides chronica is reported. A 20-year-old girl presented with mildly pruritic viola- ceous papules and plaques on the face, trunk and extremities for about 20 years. The scaly lesions were arranged in linear or reticular patterns. Discrete follicular papules could be seen. Auspitz sign was negative. There was no oral mucosa, eye and nail involvement. Histiopathological examination demonstrated hyperkeratosis, parakeratosis and irregular acanthosis with in- creased melanin in the basal cell layer. Colloid bodies and focal liquefaction degeneration with band-like infiltration of in- flammatory ceils mainly composed of lymphocytes and histiocytes in the upper dermis could be noticed. These findings were consistent with the diagnosis of keratosis liebenoides chronica. After the treatment with tretinoin for 6 months, the papules and plaques were flattened.