双手背多发结节型环状肉芽肿一例

A case of nodular pattern granuloma annulare on both hands

51岁女性患者,双手背结节逐渐增多伴压痛10年,否认关节痛病史。系统检查无异常。皮损组织病理学示真皮及皮下组织内组织细胞形成的栅栏状肉芽肿,中央可见胶原纤维变性。辅助检查:类风湿因子(RF)及抗溶血性链球菌O (ASO)阴性,血尿酸值正常,结核菌纯蛋白衍生物(PPD)试验阴性,胸部X线片示双肺纹理增多,自身抗体谱阴性。结合临床诊断:结节型环状肉芽肿。给予沙利度胺口服及皮损内曲安奈德注射治疗后皮损大部分消退。

A 51-year-old female presented with multiple skin colour nodules on dorsal side of both hands,with tenderness and had been slowly enlarging for about 10 years and without arthralgia.The system checks found no abnormality.Histopathological examination revealed collagenous degeneration surrounded with peripheral palisade histocytes in dermis and subcutaneous tissue.RF(rheumatoid factors),ASO(anti-Streptolysin "0"),serum uric acid and autoantibody profile were normal.PPD test was negative and chest X-ray showed increased lung texture.Combined with the clinical manifestations,the patient was diagnosed as nodular pattern granuloma annulare.After the treatment of oral thalidomide and injection of triamcinolone acetonide,the nodules subsided significantly.