硬红斑24年的治疗与随访

Erythema induratum of bazin: a case report of 24-years follow-up

患者女,34岁。双小腿反复出现红斑、结节、溃疡24年。患者24年来反复发作5次类似皮疹,每次主要为单发,药物治疗不同,最终以大小不一的色素性萎缩性瘢痕性愈合。共行3次皮损组织病理检查,均符合硬红斑病理改变。患者2次结核菌纯蛋白衍生物(PPD)试验强阳性,一次γ-干扰素释放试验阳性。16岁时被确诊为肺结核,并规则四联抗结核治疗1年后痊愈。本文总结反复发作24年的硬红斑治疗经验。

A 34-year-old woman present with recurrent erythema,nodules and ulcers in her lower legs on/off for the last 24 years.She reported 5 episodes of similar eruptions in the past 24 years.The eruption was solitary,treated with different drugs and resolved with pigmented atrophic scar.The biopsy was performed three times and showed the histological changes consistent with erythema induratum of Bazin.The patient had PPD done twice,and both PPD tests were strongly positive,PPD(++++).A test for γ-interferon release test was positive.The patient was diagnosed as pulmonary tuberculosis when she was 16 years old,and recovered after 1 year of regular quadruple anti-tuberculosis treatment(ATT).This is a case of recurrent erythema induratum of 24 years follow-up.We summarized our experiences in treating recurrent erythema induratum.