发疹型扁平苔藓1例

A case of eruptive lichen planus

报告1例发疹型扁平苔藓。患者男,69岁。全身暗红斑、丘疹伴瘙痒5个月。血糖升高9年余。皮肤专科检查:头面部、躯干及四肢可见暗红斑,部分融合成片,部分苔藓样肥厚明显,伴扁平丘疹及斑块,上覆细薄鳞屑,头部皮肤脱屑明显,未见束状发。口腔颊黏膜可见Wickham纹,生殖器黏膜见白色斑疹。皮损组织病理:表皮缺损,真皮浅层见带状的淋巴组织浸润,见色素失禁。PAS染色阴性。诊断:发疹型扁平苔藓;2型糖尿病。予小剂量激素联合羟氯喹治疗1个月后,遗留色素沉着斑,无新发皮疹。

A case of eruptive lichen planus is reported.A 69-year-old man had generalized dark red erythema and papules with pruritus for 5 months.Dermatological examination showed dark red erythema on the head,face,trunk and limbs,some of which were hypertrophic lichenoid and flat papules covered by fine scales.Dandruff was present on the scalp,with no hair bundles.Wickham marks were seen on oral buccal mucosa,and white macules were seen on genital mucosa.Histopathology of skin lesions showed epidermal defect,band-like lymphocytic infiltration and pigment incontinence in the superficial dermis.PAS staining was negative.The diagnosis was eruption lichen planus.After 1 month of treatment with low dose glucocorticoid combined with hydroxychloroquine,hyperpigmentation was left with no new rash.