营养缺乏所致坏死松解性游走性红斑样皮损

Necrolytic migratory erythema-like dermatitis with malabsorption: a case report

报告1例不伴高胰岛素瘤综合征的坏死松解性游走性红斑样皮损表现的营养缺乏性疾病。患者女,62岁。双小腿红斑反复发作3年,躯干与四肢红斑、结痂、脱屑近1年,皮疹呈周期性发作和缓解,伴有舌炎,呈营养不良状态。组织病理示表皮浅层坏死,棘层增厚,真皮乳头水肿,血管扩张,真皮浅层中等量中性粒细胞、淋巴细胞为主浸润;胰高血糖素238.56 ng/L,胸腹部及盆腔CT检查未见实体肿瘤。诊断为营养缺乏所致坏死松解性游走性红斑样皮损。给予补充复方氨基酸、维生素等对症支持治疗,皮损10 d内缓解。随访6个月,未见大面积反复。

A case of necrolytic migratory erythema-like dermatitis in a patient with malabsorption,without glucagonoma syndrome is reported.A 62-year-old female presented with erythematous patches/laques on both lower legs for 3 years,and erythematous patches/plaques with crusting and scaling on her truck and extremities for nearly 1 year.The patient experienced periodic disease flare-ups,followed by remission.She also suffered from glossitis and malnutrition.Histopathological examination showed superficial epidermal necrolysis,thickening of spinous layei;papillary dermal edema,vasodilation,and an infiltration of predominantly lymphocytes mixed with some neutrophils in the superficial dermis.The level of glucagon was 238.56 ng/L Systemic evaluation showed no evidence of tumor.The diagnosis of necrolytic migratory erythema-like dermatitis with malabsorption was confirmed.The condition was relieved in ten days after supplementation with compound amino acids and vitamins.There was no recurrence of the disease after a follow-up of 6 months.