复发性皮肤坏死性嗜酸性血管炎一例并文献复习

Recurrent cutaneous necrotizing eosinophilic vasculitis: a case report and literatures review

报道1例复发性皮肤坏死性嗜酸性血管炎并对相关文献进行复习。患者,女,64岁。因双下肢痛性皮疹12天就诊。偶有干咳,无哮喘病史。皮肤科查体:双下肢散在紫红色斑片、斑块,胫前数个结节、血疱样损害;右前臂有少量类似损害。外周血嗜酸粒细胞计数增多。胸部X线提示双肺渗出性改变。皮损组织病理符合皮肤坏死性嗜酸性血管炎。口服泼尼松45 mg/d治疗1周后临床症状明显好转,糖皮质激素减量过程中曾有复发。

One case with recurrent cutaneous necrotizing eosinophilic vasculitis(RCNEV） is reported andrelated literatures are reviewed. A 64-year-old female presented with painful lesions on the lower limbs for 12 days with dry cough occasionally. Dermatological examination showed purple red patches and plaques localized on the lower limbs,several nodules,bloody blisters on the bilateral anterior tibias and few similar lesions on the right forearm. Peripheral blood eosinophil count was increased. Chest X-ray indicated bilateral exudative changes. The histopathological manifestation was consistent with the diagnosis of RCNEV. The patient was initially given 45 mg of prednisone daily with a significant improvement in clinical symptoms after one week’s treatment. However,the recurrence was seen during tapering of prednisone.