儿童肢端假性淋巴瘤样血管角皮瘤一例临床病理特征

Clinical and pathological features of acral pseudolymphomatous angiokeratoma of children:a case report

患儿女,13岁,右足部皮疹伴瘙痒5年。皮肤科检查:右足弓内侧散在紫红色扁平丘疹,表面轻微鳞屑,右拇趾外侧散在淡红色丘疹,右足跟散在圆顶紫红色丘疹,基底外周领圈状角化。右足跟丘疹组织病理学检查:表皮角化过度,两侧显著角化过度,颗粒层增厚,棘层无明显增生,基底层局灶液化变性,真皮层大量淋巴细胞、浆细胞增生浸润,无异形性,其中可见较多的中小厚壁血管,管腔扩张,内衬突出饱满的内皮细胞。诊断:儿童肢端假性淋巴瘤样血管角皮瘤。治疗:Nd:YAG长脉宽1064 nm激光每月治疗1次,治疗7次后,皮疹较前消退,数目减少。

A 13-year-old female patient presented with itchy rashes on the right foot for 5 years.Skin examination revealed scattered flat,reddish-purple,slightly scaling papules on the inner side of the arch of the right foot,scattered light red papules on the outer side of the right great toe,and scattered domed reddish-purple papules on the right heel with collar-shaped keratinization around the base.Histopathological examination of the papule on the right heel revealed epidermal hyperkeratosis,marked hyperkeratosis around the papule,thickened granular layer and focal liquefaction degeneration of the basal layer with no obvious hyperplasia of the spinous layer;a large number of lymphocytes and plasma cells without atypia infiltrated the dermis,in which there were many small-and medium-sized dilated thick-walled blood vessels lined with prominent plump endothelial cells.The patient was diagnosed with acral pseudolymphomatous angiokeratoma of children,and treated with long-pulsed 1064-nm Nd:YAG laser once every month.After 7 sessions of treatment,the rashes regressed and decreased in number.