融合性网状乳头瘤病误诊为苔藓性皮肤淀粉样变一例

A case of confluent and reticulate papillomatosis misdiagnosed as lichenoid amyloidosis

18岁女性患者,躯干部褐色斑丘疹伴痒痛3个月,初诊误诊为苔藓性皮肤淀粉样变。进一步皮肤组织病理检查示:表皮角化过度,乳头瘤样增生,真皮血管周围少量淋巴细胞浸润。结合临床表现、病史特点、组织病理改变,修正诊断为融合性网状乳头瘤病。给予阿维A胶囊10 mg每日1次口服、复方甘草酸苷片50 mg每日3次口服;0.1%维A酸乳膏每日2次外用;311 nm窄谱中波紫外线隔日1次照射等综合治疗。10 d后,皮损变薄,24 d后皮损大部分消退,随访半年无复发。

A 18-year-old female patient presented with brown macules on trunk with itching and pain for 3 months, according to the clinical manifestations the patient was misdiagnosed as lichenoid amyloidosis. Skin biopsy revealed that： hyperkeratosis, papillomatous hyperplasia, dermal perivascular lymphocytes infiltration. According to the clinical manifestations, history characteristics and histopathological findings, the final diagnosis was considered as confluent and reticulate papillomatosis. The treatment scheme was as follows： acitretin capsule 10mg qd orally; Compound Glycyrrhizin Tablets 50mg tid orally; 0.1% tretinoin cream locally applied bid and combined with NB-UVB radiation therapy quaque die alterna. After 10 days of the treatment, the skin lesions became thinner gradually, and twenty-four days later, most of the skin lesions subsided. Follow up for 6 months, the lesions had no recurrence.