泛发性皮肤垢着病1例

A case of generalized dermatosis

报告1例泛发性皮肤垢着病。患者男,16岁,躯干、四肢黑褐色皮疹10年。皮肤科检查:躯干、四肢皮肤见大量群集米粒至绿豆大小丘疹,上覆黑褐色污垢状角质状鳞屑,质地偏硬,干燥,不易剥离,境界清楚,周围可见棕褐色小片状鳞屑。辅助检查:真菌涂片(-),糠枇孢子菌(-)。皮损组织病理活检示:表皮团状或不规则角化亢进,毛囊角栓,棘层不规则增厚,皮突延长,基底细胞层黑素颗粒增多,真皮浅层血管周围少量淋巴细胞、组织细胞浸润。结合临床及病理,诊断为泛发性皮肤垢着症。予阿达帕林软膏治疗两周,原发皮损基本消退,电话随访至今,病情稳定,未复发。

A 16-year-old male presented with dark-brown rashes on his torso and limbs for 10 years.Dermatological examination showed a large number of clusters of papules with dark brown grime like keratinous scales,size range from rice grains to mung beans on the torso and limbs.The skin was hard,dry and difficult to peel off.The boundaries were clear,and brown flaky scales were visible around.Supplementary examination:fungal smear(-),bran spores(-).Pathological examination showed mass or irregular hyperkeratosis of the epidermis,hair follicle horn thrombus,irregular thickening of the spinous layer,prolonged dermal process,increased melanin granules in the basal cell layer,and a small number of lymphocytes and histocytes around the superficial dermal vessels.Comprehensive clinical and pathological diagnosis of generalized skin scaling syndrome.After two weeks treatment with adapalene ointment,the primary lesions basically subsided,and the patient’s condition was stable without recurrence.