类风湿性嗜中性皮炎1例

A Case of Rheumatoid Neutrophilic Dermatitis

患者女,31岁,反复全身红斑、丘疹、结节伴瘙痒2年。类风湿因子测定为60.70 IU/mL,抗环瓜氨酸肽抗体115.39 RU/mL;皮损组织病理示:表皮呈银屑病样增生,真皮浅层及深层血管周围炎,浸润的炎症细胞以嗜中性粒细胞、淋巴细胞及浆细胞为主,脂肪小叶周围见较多嗜中性粒细胞及少量淋巴细胞、浆细胞浸润,伴大片胶原变性、红染。诊断:类风湿性嗜中性皮炎。

A 31-year-old female presented pruritus, erythemas, papules and nodules all over the body for two years. Levels of rheumatoid factor and anti-cyclic citrullinated peptide antibody were 60.70 IU/mL and 115.39 RU/mL, respectively. Histological examination of the skin lesion showed psoriatic hyperplasia in the epidermis, perivascular infiltrates of predominantly neutrophils, lymphocytes, and plasma cells in the superficial and deep dermis. In addition to collagen degeneration and positive for eosin staining, abundant neutrophils, a few lymphocytes and plasma cells were also observed around fat lobules. The diagnosis of rheumatoid neutrophilic dermatitis was made.