以眼睑和头皮红斑为表现的早期皮肤型红斑狼疮一例

Early cutaneous lupus erythematosus characterized by erythema of the eyelids and scalp:a case report

患者,女,29岁。左眼睑红斑3个月,发现头皮脱发区1天。头皮组织病理:表皮轻度角化过度,基底细胞灶性液化变性,真皮浅层血管周围少许单一核细胞浸润,真皮内毛囊数量明显减少,真皮深层毛囊及附属器周围较多淋巴细胞浸润。免疫荧光:表皮基底膜C3、IgM、IgA弱阳性带状沉积,IgG阴性。阿新蓝染色:胶原间黏蛋白沉积。诊断为皮肤红斑狼疮。给予硫酸羟氯喹片口服、他克莫司软膏和卤米松软膏外用治疗,红斑消退。

A 29-year-old female presented with erythmia on the left eyelid for more than 3 months and hair loss area found on scalp for 1 day,ANA and RNP/Sm were all positive,pathological examination showed mild hyperkeratosis of the epidermis,focal vacuolar alteration of the basal cell layer,lymphocytes infiltrate around deep dermis and appendages.Immunofluorescence:epidermal basement membrane C3,IgM,IgA weakly positive banded deposition,IgG negative.Collagen intermucin deposition.The case was diagnosed as cutaneous lupus erythematosus and was treated with oral hydroxychloroquine,topical tacrolimus and halometasone ointment.The erythema subsided and the condition of the case improved.