皮肤克罗恩病

A case of cutaneous Crohn’s disease

报告1例皮肤克罗恩病。患者男,20岁。肛周肿物9个月,增大伴腹痛及腹泻7个月余。皮肤科检查:肛周皮肤可见不规则疣状结节及斑块,疣状向外突起,表面尚光滑,未见异常分泌物。肛周皮损组织病理检查:炎性息肉伴鳞状上皮假上皮瘤样增生,上皮下可见多个小灶上皮样肉芽肿,伴多核巨细胞反应,较多急、慢性炎性细胞浸润及肉芽组织。诊断:皮肤克罗恩病。先予口服美沙拉嗪及柳氮磺胺吡啶抗炎治疗无效后,于第0周、2周及6周静脉滴注英夫利昔单抗(5 mg/kg)治疗,治疗后肛周结节明显缩小,目前仍在随访中。

A case of cutaneous Crohn’s disease is reported.A 20-year-old male presented with increased perianal mass for 9 months,accompanied by abdominal pain and diarrhea for more than 7 months.Dermatological examination showed irregular verrucous nodules and plaques on the perianal skin,with verrucous protrusions,smooth surface,and no abnormal secretions.Histopathological examination revealed inflammatory polyps with squamous epithelial pseudoepithelioma-like hyperplasia,multiple small foci of epithelioid granuloma under the epithelium,with polynuclear giant cell reaction,a large amount of acute and chronic inflammatory cell infiltration and granulation tissue.The diagnosis of cutaneous Crohn’s disease was made.The initial anti-inflammatory treatment with mesalazine and sulfasalazine was ineffective,and thus infliximab(5 mg/kg)was administered intravenously at Week 0,2 and 6.The perianal nodules were significantly reduced after therapy,and the follow-up is still underway.