头皮糜烂性脓疱性皮病1例

A case of erosive pustular dermatitis of scalp

报告1例头皮糜烂性脓疱性皮病。患者女,82岁,因右侧头皮颞部反复出现红斑、脓疱、糜烂、结痂3个月就诊。皮肤科检查:右侧头皮颞部见大片红斑、糜烂、结痂,中间部分毛发脱落,皮肤轻度萎缩,浅表疤痕形成。皮损组织病理示:浅表糜烂结痂,表皮不规则增生,部分表皮轻度萎缩,真皮浅层可见以淋巴、组织细胞、浆细胞及少量中性粒细胞为主的混合炎症细胞浸润,毛囊萎缩,数量减少,局部仅见立毛肌,毛囊结构消失,部分区域胶原纤维增生硬化,PAS染色与抗酸染色均阴性。诊断:头皮糜烂性脓疱性皮病。治疗:予以口服异维A酸,外涂他克莫司与卡泊三醇软膏,皮疹较前稍好转。现随访观察中。

We present a case of erosive pustular dermatitis of scalp with recurrent erythema, pustules, erosion, and scab in the right temporal region of the scalp for 3 months. Dermatological examination showed a large area of erythema, erosion, scab, hair loss in the middle part, mild skin atrophy, superficial scar formation in the right temporal area of the scalp. Histopathologic examination showed superficial erosion, irregular hyperplasia of epidermis, part of the skin mild atrophy, leather shallow visible in lymphoid tissue cells, plasma cells, and a small amount of neutrophils predominate a mixture of inflammatory cells infiltration, hair follicle atrophy, decreased, local only piloerection muscle, hair follicle structure disappears, area of the collagen fiber hyperplasia of hardening. PAS dying with acid were negative. Erosive pustular dermatitis of scalp was diagnosed. Oral isotretinoin was given, and topically coated with tacrolimus and calcipotriene ointment.